ABSTRACT
The fungus Purpureocillium lilacinum previously known as Paceliomyces lilacinus is an emerging pathogen that can cause severe human infections including devastating oculomycosis. Treatment with traditional antifungals often fails, and the organism shows variable susceptibility to novel triazoles. We hereby report a case of keratomycosis caused by Pur. lilacinum in an immunocompetent male patient following trauma. The patient was successfully treated with voriconazole. The drug shows good activity against Pur. lilacinum and could be a promising therapeutic alternative to treat infections caused by this fungus, which generally shows resistance to conventional antifungal agents including novel triazoles.
ABSTRACT
Oculomycosis is a major cause of visual impairment. Eye pain, redness, discharge, diminution and photophobia are presenting features. We collected corneal scraping, vitreous, aqueous fluids and conjunctival swabs after the slit‑lamp examination. Ophthalmological findings were hypopyon, stromal congestion, conjunctival congestion and epithelial defect. Direct microscopy of 10% potassium hydroxide (KOH) wet mounts, gram staining, fungal and bacterial cultures were performed. Fungal isolates were obtained in 24% patients with equal number of both sexes and average age 49 years. KOH revealed fungi in 73% samples and 43.33% were positive on Gram staining. Fusarium spp. (36.66%), Aspergillus spp. (23.33%) and melanised fungi (20%) were common etiological agents. Fusarium spp. was more often associated with complications. Trauma was a predisposing factor in 65% cases and occurred mainly with vegetable matter. The majority responded to the conservative management with 5% natamycin and four patients required surgery.
ABSTRACT
Aims: Oculomycosis is a major cause of visual impairment and blindness in the tropical regions of the world. Practitioners’ perception of the prevalence of oculomycosis and its associated risk factors could aid in the prevention of this ocular disorder. This study therefore investigated the eye care practitioner’s perception of oculomycosis in Ghana. Study Design: A cross-sectional survey. Place and Duration of Study: Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, between January and September, 2014. Methodology: A cross-sectional survey of 120 eye care practitioners in six regions of Ghana was conducted, using a structured questionnaire, to obtain information on their perception regarding the prevalence, seasonal variations and risk factors of oculomycosis. Results: Optometrists, Ophthalmic nurses, and Ophthalmologists sampled were 43.3%, 42.5% and 14.2% respectively. More than one-third (39.2%) of the respondents reported that oculomycosis was commonly encountered in clinical practice, with the majority 66 (55.0%) stating that the prevalence was higher in April to November i.e. the planting and harvesting periods in the year. The practitioners’ perception of the prevalence of oculomycosis showed strong association with their gender (P = .01), duration of practice (P = .01), profession (P = .05) and facility type (P = .03). Risk factors commonly associated with oculomycosis were trauma from vegetative matter (80%) and non-vegetative matter (50%) and the use of herbal preparations on the eye (41.7%). Conclusion: Oculomycosis is a prevalent ocular condition encountered by eye care practitioners in Ghana, especially during the rainy season. Intensification of health education on its risk factors could help minimize or prevent occurrence of this ocular condition.