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1.
Dermatol Ther ; 31(2): e12580, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29193594

ABSTRACT

The incidence of non dermatophytic mould (NDM) onychomycosis (OM) has been steadily increasing Fusarium spp is the most common cause of NDM OM in most geographical locations. Fusarium spp and other NDMs are largely resistant to commonly used anti-fungals. The successful use of laser and light based devices has been demonstrated in dermatophytic OM, but there is no previous report of their successful use in any NDM OM. We describe a patient with OM caused by Fusarium solani spp, who was clinically (with a normal appearing nail) and mycologically (with negative microscopy and culture on repeated samples) cured of her infection following treatment with 2 sessions of Qs NdYAG (532nm and 1064nm) given 1 month apart.


Subject(s)
Foot Dermatoses/radiotherapy , Fusariosis/radiotherapy , Fusarium/radiation effects , Lasers, Solid-State/therapeutic use , Low-Level Light Therapy/instrumentation , Nails/microbiology , Onychomycosis/radiotherapy , Adult , Female , Foot Dermatoses/diagnosis , Foot Dermatoses/microbiology , Fusariosis/diagnosis , Fusariosis/microbiology , Fusarium/classification , Fusarium/isolation & purification , Humans , Onychomycosis/diagnosis , Onychomycosis/microbiology , Treatment Outcome
4.
Cornea ; 32(1): 95-7, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22673855

ABSTRACT

PURPOSE: To report the beneficial properties of argon laser as an adjunctive therapy in 2 patients with refractory fungal keratitis. METHODS: Case reports and a review of the literature. Two cases of Fusarium keratitis refractory to topical and systemic antifungals were further treated with argon laser. Before laser treatment, the eye was medicated with proparacaine 0.5%, lidocaine 4%, and a single drop of fluorescein sodium 0.25%. Argon laser irradiation of the affected cornea was performed using argon blue-green wavelength (Coherent Ultima 2000; Coherent, Inc). A spot size of 500 µm, pulse duration of 0.10 seconds, and power ranging from 500 to 900 mW were used. RESULTS: During the first week after laser treatment, both patients showed complete resolution of the infiltrates. Two signs were observed during the procedure: a blanching of the corneal stroma and small cavitations that reached the middle stroma. No adverse effects were observed. CONCLUSIONS: Argon laser phototherapy is useful as an adjunctive treatment of refractory fungal keratitis. More cases are needed to validate our findings.


Subject(s)
Corneal Ulcer/radiotherapy , Eye Infections, Fungal/radiotherapy , Fusariosis/radiotherapy , Fusarium/isolation & purification , Lasers, Gas/therapeutic use , Low-Level Light Therapy , Adult , Aged, 80 and over , Antifungal Agents/therapeutic use , Drug Resistance, Fungal , Humans , Male , Visual Acuity/physiology
5.
Cornea ; 31(2): 176-80, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22081155

ABSTRACT

PURPOSE: To evaluate the efficacy of corneal cross-linking (CXL) (riboflavin-UV-A) as a simple therapy in Fusarium keratitis. METHODS: Twenty-four rabbits were systemically anesthetized, and the stromata of their right corneas were inoculated with Fusarium solani [10(5) colony-forming units (CFU) per milliliter]. Rabbits were divided into 2 groups: one was treated with CXL 72 hours after infection and the other did not receive any treatment (control). All eyes in both the groups were examined before (days 0 and 3) and after (day 7) CXL treatment. The eyes were enucleated, and corneal buttons were sent for microbiological and histological examinations. RESULTS: All animals developed Fusarium keratitis; there was no statistically significant difference between groups before treatment (day 0, P = 0.397 and day 3, P = 0.702). After CXL treatment, the difference in clinical scores on day 7 between groups was statistically significant (P = 0.00); the CXL group showed significant lower clinical score. The CXL group had 22.45 ± 5.09 CFU/g compared with 42.5 ± 3.12 CFU/g in the control group; this difference was statistically significant (P = 0.01). In the 3 buttons of the control group, similar amounts of Fusarium hyphae and inflammatory cells were observed. In 2 of the 3 buttons analyzed from the CXL group, fewer Fusarium hyphae, inflammatory cells, and nonspecific stromal changes were observed compared with the control group. CONCLUSIONS: Treatment of fungal keratitis with CXL seems to be effective in decreasing the intensity and severity of infectious keratitis by F. solani. This therapy may be useful as a coadjuvant in the medical treatment of resistant infections.


Subject(s)
Eye Infections, Fungal/radiotherapy , Fusariosis/radiotherapy , Keratitis/radiotherapy , Ultraviolet Therapy , Animals , Colony Count, Microbial , Disease Models, Animal , Eye Infections, Fungal/microbiology , Fusariosis/microbiology , Fusarium/isolation & purification , Keratitis/microbiology , Photosensitizing Agents/therapeutic use , Rabbits , Riboflavin/therapeutic use
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