4 years ago

Fusarium Keratitis in Germany.

Geerling G, von Lilienfeld-Toal M, Cornely OA, Hamprecht A, Roth M, Mackenzie CR, Kaerger K, Walther G, Kurzai O, Stasch S
Fusarium keratitis is a destructive eye infection that is difficult to treat and which results in poor outcome. In the tropical and subtropical areas the infection is relatively common and associated with trauma or chronic eye diseases. However, in recent years, an increased incidence has been reported in temperate climate regions. At the German National Reference Center, we observed a steady increase in case numbers since 2014. Here, we present the first German case series of eye infections with Fusarium spp. We identified Fusarium isolates from the eye or eye-related material from 22 patients in 2014 and 2015. Thirteen isolates belonged to the Fusarium solani species complex (FSSC), 6 belonged to the Fusarium oxysporum species complex (FOSC) and three to the Fusarium fujikori species complex (FFSC). FSSC was isolated in 13 of 15 (85 %) definite infections and FOSC in 3 of 4 (75 %) definite contaminations. Furthermore, diagnosis from contact lens swabs or culture of contact lens solution turned out to be highly unreliable. FSSC isolates differed from FOSC and FFSC by distinctly higher minimal inhibitory concentration (MIC) for terbinafine. Outcome was often adverse with 10 patients requiring keratoplasty or enucleation. The use of natamycin as the most effective agent in keratitis caused by filamentous fungi was rare in Germany, possibly due to restricted availability. Keratitis caused by Fusarium spp. (usually FSSC) appears to be a relevant clinical problem in Germany with the use of contact lenses as the predominant risk factor and an adverse outcome.

Publisher URL: https://www.ncbi.nlm.nih.gov/pubmed/28747368

DOI: PubMed:28747368

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