• 作者：Virginia Vanzzini Zago^a ; ^{vivanzzini@yahoo.com} ; Patricia Manzano-Gayosso^b ; Francisca Hern&#225 ; ndez-Hern&#225 ; ndez^b ; Luis Javier Mé ; ndez-Tovar^c ; Alfredo Gó ; mez-Leal^a ; Rubé ; n Ló ; pez Martí ; nez^b
• 关键词：Fusarium ; Aspergillus ; Dematiá ; ceos ; Candida ; Queratomicosis ; Recubrimientos conjuntivales ; Evisceraciones
• 刊名：Revista Iberoamericana de Micolog¨ªa
• 出版年：2010
• 出版时间：April-June 2010
• 年：2010
• 卷：27
• 期：2
• 页码：57-61
• 全文大小：391 K

Background

Some of the most common precipitating events for keratomycoses (fungal keratitis), include surgical trauma (after cornea transplantation), the use of contaminated contact lenses or alterations in lacrimal secretions. Diagnosis and treatment (to avoid loss of vision) for these type of infections are challenging.

Objective

Retrospective review of the diagnosis, epidemiology, etiology and response to treatment in 219 patients with fungal keratitis in Mexico.

Methods

We have studied the diagnosis, epidemiology, etiology and response to treatment in 219 patients from different states in the Mexican Republic in the Cornea Department at an Ophthalmology Hospital in Mexico D.F.

Results

Trauma was the precipitating event in 77 patients (36 % ), of which 12 (5.4 % ) were due to surgical trauma; 152 patients (64.8 % ) did not report any prior trauma. There were 165 male (75.3 % ) and 54 female (24.6 % ) patients, with an average age of 46 years old. For clinical and visual treatment patients were treated with topical and oral antifungals and surgery. One or more surgeries were performed on a total of 81 patients (36.9 % ). A total of 62 patients (28.3 % ) received a corneal transplant, and 19 patients (8.7 % ) were subjected to conjunctival flap or scleral-conjunctival surgery.

Conclusions

In Mexico, keratomycoses affect mostly male patients in a 4:1 ratio over females. Fusarium solani was the most frequent agent of fungal keratitis in our study (37.2 % ), and the highest number of corneal ulcers and eviscerations (26 % ) was present in patients infected by Aspergillus. The best therapeutic responses were with combination of topical antifungals against dematiaceous fungi.