Fungal Keratitis: Epidemiological Profile in Argentina

Purpose of Review

The purpose of this review is to describe the epidemiology and species distribution of fungi-causing keratitis in Argentina during the past 10 years.

Recent Findings

In Argentina, reports of distribution and frequency of fungal keratitis are scarce and little is known about its current epidemiology.In the present study, a review of the published data on fungal keratitis was done according to the global context focusing on the current situation in our country.

Summary

Data presented here were obtained in a reference ophthalmological hospital in the Autonomous city of Buenos Aires from 2007 to 2017 and represents an approach to the current status of fungal keratitis. However, larger national data is required to assess the actual epidemiological situation in Argentina.

     

Review and Update on the Epidemiology,Clinical Presentation,Diagnosis, and Treatment of Fungal Keratitis

Current Fungal Infection Reports - Fungal keratitis is a leading cause of ocular morbidity worldwide. Globally, there has been a steady increase in the prevalence of fungal keratitis, yet the...     

张家口地区真菌性角膜炎病原菌的临床分析

目的：分析张家口地区真菌性角膜炎的病原学及流行病学特征,为其临床诊治提供一定的参考依据。方法：回顾性分析2010年12月-2012年6月我院收治的97例真菌性角膜炎患者的临床资料,分析其病原菌的构成、诊断方法及药物敏感性情况。结果：总共鉴定出84株真菌,分属12个属、23个种,其中以镰刀菌属感染最为多见（51．2％）,其次为曲霉属（14．3％）和假丝酵母属（10．7％）;感染者以男性劳动者居多,外伤是最常见的诱因,秋冬季为高发季节;不同菌种对药物的敏感性存在区别,主要致病菌种对两性霉素B和纳他霉素的敏感性均达70％以上,较其它抗真菌药物高。结论：镰刀菌为本地区真菌性角膜炎的主要致病菌,病原体种类和构成与其他北方地区无明显区别。两性霉素B和纳他霉素为大多数菌种的敏感药物,可作为本地区临床预防和治疗的首选药物。     

Fungal Keratitis Caused by Colletotrichum dematium: Case Study and Review

Mycopathologia - Colletotrichum species are known as important pathogens of plants with an impact on crop production. Some of these species are also known as a cause of rare ophthalmic infections...     

Rare Fungal Keratitis Caused by Coprinellus Radians

Mycopathologia - A case of fungal keratitis due to Coprinellus radians is reported. To our knowledge, fungal keratitis caused by this species was rare. Fungal hyphae were detected in corneal...     

中枢神经系统真菌感染的诊断与治疗

分析中枢神经系统真菌感染患者的临床特征、预后及其影响因素。收集我院2001年1月至2009年12月收治的42例中枢神经系统真菌感染患者的临床资料,对患者的诊断与误诊、实验室和病原学检查、治疗与预后等进行回顾性统计分析。42例患者中合并其他疾病者29例,占69.0%;首诊误诊32例,占76.2%。两性霉素B(AmpB)治疗者25例,其中6例在疾病早期联合5-氟胞嘧啶治疗,15例单用氟康唑治疗。治愈20例,占47.6%;好转11例,占26.2%;死亡11例,占26.2%。中枢神经系统真菌感染误诊率高,各种原因所致的免疫缺陷是引发中枢神经系统真菌感染的主要危险因素,尽早明确诊断,联合AmpB与5-FC抗真菌治疗、积极控制颅内压是降低病死率及改善预后的关键。     

Fungal Paronychia. Clinical,Diagnosis and Treatment Aspects

Purpose of Review

The purpose of this study is to recognize and expand the knowledge of mycotic paronychia as a variable clinical condition due to various predisposing factors and multiple fungal organisms.

Recent Findings

Candida-associated mycotic paronychia is common but other non-dermatophyte molds, such as Fusarium, are identified as potential agents of paronychia and onychomycosis.

Summary

Mycotic paronychia is characterized by inflammation of the proximal or lateral nail folds caused by certain fungi. Mycological analysis is necessary to identify the causal agent and prescribe an appropriate treatment. Further studies are needed to know the involved microorganisms in the disease and the pathogenicity factors involved in this localized area of the nail apparatus.

     

Tissue Diagnosis of Invasive Fungal Infections: Current Limitations and the Emerging Use of Molecular Techniques

Invasive fungal diseases (IFD) due to opportunistic fungi are commonly treated using empirical antifungal therapy. Therefore, a comprehensive study of organisms associated with IFD is essential to define successful empiric therapies in each setting. Current diagnostic tests, such as culture, histology and serology are suboptimal, leading to delays in the initiation of antifungal therapies and resulting in high mortality rates despite the availability of several new antifungal agents. Using molecular methods to identify fungal pathogens directly from formalin-fixed, paraffin-embedded tissues is emerging as a diagnostic approach. The goal of this molecular approach is to complement conventional diagnostic tests through the reliable detection and identification of fungal nucleic acids or antigens in tissues so as to direct antiinfective therapies and improve patient outcomes. Here we review challenges and recent advances in the identification of fungal pathogens from tissue samples by conventional and molecular methods.     

Clinical Characteristics and Outcomes of Rare Fungal Keratitis Caused by Verticillium dahliae

Mycopathologia - To observe clinical characteristics and treatment outcomes of fungal keratitis caused by Verticillium dahliae. Clinical data of 7 patients diagnosed as fungal keratitis...     

多重PCR对真菌性角膜炎主要致病菌的菌属鉴定

目的:建立多重PCR体系对真菌性角膜炎主要致病真菌进行快速诊断并同时进行菌属鉴定的方法。方法:建立两个多重PCR体系(体系1和体系2),对真菌性角膜炎九种主要致病真菌DNA进行检测,观察该体系对真菌临床菌株、人类基因组及其他眼部常见致病微生物DNA的检测结果。结果:体系1对镰孢菌属扩增均产生约360bp的特异产物,对曲霉菌属、牵连青霉菌和新月弯孢菌扩增均产生约470bp的特异产物。体系2对镰孢菌属、曲霉菌属均无特异产物,而对牵连青霉菌产生了360bp的特异产物,对新月弯孢霉产生了300bp的特异产物。根据DNA模板在两个多重PCR体系中扩增出的不同特异条带可将九种真菌分为四个菌属。57株真菌临床菌株中55株的鉴定结果与常规鉴定结果一致。两体系对人类基因组及其他眼部常见致病微生物DNA的扩增结果均为阴性。结论:通过两个多重PCR体系检测可将真菌性角膜炎在菌属水平进行诊断及鉴定。该方法具有快速、简便、特异、灵敏的特点,具有较好的临床应用前景。     

尿道损伤的诊断治疗现状

尿道损伤一直是个棘手的泌尿外科常见疾病.逆行尿道造影是评价尿道损伤的金标准.尿道损伤的治疗方法的选择在泌尿系创伤中是争议最多的.目前没有一种方法是最简单有效的处理方法.组织工程技术的诞生和发展,给尿道损伤的处理带来了新的希望,有望为尿道损伤的修复提供新的材料.本文仅就尿道损伤疾病的基本概况及国内外在诊断和治疗方面的的研究现状作简要综述.     

尿道损伤的诊断治疗现状

尿道损伤一直是个棘手的泌尿外科常见疾病。逆行尿道造影是评价尿道损伤的金标准。尿道损伤的治疗方法的选择在泌尿系创伤中是争议最多的。目前没有一种方法是最简单有效的处理方法。组织工程技术的诞生和发展,给尿道损伤的处理带来了新的希望,有望为尿道损伤的修复提供新的材料。本文仅就尿道损伤疾病的基本概况及国内外在诊断和治疗方面的的研究现状作简要综述。     

Fungal Vaccines and Immunotherapeutics: Current Concepts and Future Challenges

Purpose of review

The remarkable advances in modern medicine have paradoxically resulted in a rapidly expanding population of immunocompromised patients displaying extreme susceptibility to life-threatening fungal infections. There are currently no licensed vaccines, and the prophylaxis and therapy of fungal infections in at-risk individuals remains challenging, contributing to undesirable mortality and morbidity rates. The design of successful antifungal preventive approaches has been hampered by an insufficient understanding of the dynamics of the host-fungus interaction and the mechanisms that underlie heterogenous immune responses to vaccines and immunotherapy.

Recent findings

Recent advances in proteomics and glycomics have contributed to the identification of candidate antigens for use in subunit vaccines, novel adjuvants, and delivery systems to boost the efficacy of protective vaccination responses that are becoming available, and several targets are being exploited in immunotherapeutic approaches.

Summary

We review some of the emerging concepts as well as the inherent challenges to the development of fungal vaccines and immunotherapies to protect at-risk individuals.

     

Rare Invasive Fungal Infections: Epidemiology, Diagnosis and Management

Rare yeast and filamentous fungi belonging to hyalohyphomycetes (e.g., Scedosporium, Fusarium), zygomycetes and dematiaceous (e.g., Alternaria, Bipolaris) are implicated in human infections ranging from colonization and localized infections in immunocompetent individuals to fungemias and disseminated diseases in immunocompromised patients and accounting <10 % of all isolated fungal pathogens. The diagnosis of yeast, Fusarium and Scedosporium infections is based on blood cultures and of filamentous fungal infections on histopathology, direct microscopy and culture of infected tissues. The panfungal marker 1,3-b-D glucan test as well as cross reaction with antigen tests for other fungi can be used; whereas, PCR assays have been developed for direct detection of these fungi in blood and in tissues. Amphotericin B is the drug of choice for most rare yeast infections except for Trichosporon infections where voriconazole is used. The management of the other infections includes surgery combined with antifungal therapy mainly with amphotericin B for zygomycetes, voriconazole or amphotericin B for hyalohyphomycetes, and itraconazole or amphotericin B for dematiaceous fungi.     

Raman Microspectroscopy Analysis in the Treatment of Acanthamoeba Keratitis

Acanthamoeba keratitis is a rare but serious corneal disease, often observed in contact lens wearers. Clinical treatment of infected patients frequently involves the use of polyhexamethylene biguanide (PHMB), a polymer used as a disinfectant and antiseptic, which is toxic also for the epithelial cells of the cornea. Prompt and effective diagnostic tools are hence highly desiderable for both starting early therapy and timely suspension of the treatment. In this work we use Raman microspectroscopy to analyse in vitro a single Acanthamoeba cell in cystic phase. In particular, we investigate the effect of PHMB at the single-cell level, providing useful information on both the underlying biochemical mechanism and the time frame for Acanthamoeba eradication in ocular infections. Furthermore, we demonstrate that Raman spectroscopy, in conjunction with standard multivariate analysis methods, allows discriminating between live and dead Acanthamoebas, which is fundamental to optimizing patients’ treatment.