Abstract
Purpose. Alternaria spp. are an uncommon cause of mycotic keratitis. Previous studies on Alternaria keratitis have generally been limited to case reports. We examined the clinical characteristics of Alternaria keratitis in this study. Methods. The characteristics and outcomes of 7 patients with culture-proven Alternaria keratitis treated in our hospital were compared with 25 previously reported cases. Results. The risk factors for Alternaria keratitis were trauma in 5 patients and soft contact lenses in 1 patient. Six patients with early diagnosis (<2 weeks) were cured with medical antimicrobial treatment; a patch graft was required in 1 patient with perforation. When incorporated with previous reports on Alternaria keratitis (n = 32), 14 (44%) infections followed trauma, 10 (31%) were associated with preexisting corneal disease or previous ocular surgery, and 5 (16%) occurred in soft contact lens wearers. Successful medical treatment was achieved in 23 (72%) patients, including 10 out of 21 eyes (48%) treated with natamycin and/or amphotericin B. Therapeutic penetrating keratoplasty was performed in 9 (28%) cases. Conclusions. Alternaria keratitis is generally associated with specific risk factors and responds to medical treatment when early diagnosis is performed and prompt antifungal treatment is initiated.
Highlights
Alternaria is a filamentous fungus from the dematiaceous family, a group of darkly pigmented molds that are ubiquitous in soil, plants, food, and indoor air environments [1]
We performed a 10-year retrospective review of patients with culture-proven Alternaria keratitis in our hospital to study the clinical characteristics of Alternaria keratitis and compared our experience with previously reported cases
We searched the computer database of the microbiology laboratory in our hospital and reviewed the corresponding medical records to identify patients with culture-proven Alternaria keratitis, who were treated between January 1, 2003, and December 31, 2012
Summary
Alternaria is a filamentous fungus from the dematiaceous family, a group of darkly pigmented molds that are ubiquitous in soil, plants, food, and indoor air environments [1]. This fungus can cause opportunistic human infections, including cutaneous and subcutaneous infections (74.3%), oculomycosis (9.5%), invasive and noninvasive rhinosinusitis (8.1%), and onychomycosis (8.1%) [1]. Oculomycosis caused by Alternaria is primarily keratitis in patients with immunocompromised ocular surface, previous surgery, and trauma [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. We performed a 10-year retrospective review of patients with culture-proven Alternaria keratitis in our hospital to study the clinical characteristics of Alternaria keratitis and compared our experience with previously reported cases
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