Infective keratitis: a concise overview of the clinical characteristics and treatment of keratitis caused by microbial agents
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241515Keywords:
Bacteria, Virus, Fungi, Protozoa, DNA, RNA, Replication, Keratitis, Ulcer, Corneal graft, Hypopyon, Herpes, PCRAbstract
The following document provides an overview of microbial keratitis, a well-known sight-threatening inflammation of the cornea that progresses to the corneal ulcer. Sometimes, such infection is difficult to identify and cure due to the involvement of multiple pathogens implicated in the specific disorders because of similar symptoms and immunological responses. Instead of fungi and protozoa, viruses and bacteria are the most prevalent pathogens that cause microbial keratitis. A virus contains protein-encased genetic material and may infect any living creature, including bacteria and fungi, by replicating inside the host's cell and infecting neighbouring cells. Bacteria are complicated pathogens that may thrive in any media and cause harm to host cells, often through the production of toxins. Fungi are far more difficult; they spread quickly and can cause harm to several organs at the same time if the immune system is compromised. Protozas are found freely in the environment and once invade the cornea, divide quickly and become difficult to identify as well as treat, because of their involvement or in conjunction with polymicrobials. These microbes show common symptoms after invading the cornea although; their common diagnostic procedures show different results to trace out their existence in the tissue. Up to some extent, specific treatment can cure the disease with certain conditions according to a load of microbes, therefore visual status gets hampered, otherwise total loss of the eye takes place due to the endophthalmitis.
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References
Durand ML. Eye Infections. New Eng J Med. 2018;389(25):2363-75.
Prabhakar S. Keratitis. Treasure Island (FL): Stat Pearls Publishing; 2021.
Alfonso EC. Ophthalmology & Visual Sciences. Chicago Med. 2018.
Keay LJ, Gower EW, Iovieno A, Oechsler RA, Alfonso EC, Matoba A, et al. Clinical and microbiological characteristics of fungal keratitis in the United States, 2001-2007: a multicenter study external icon. Ophthalmology. 2011;118(5):920-6.
Ting DSJ, Ho CS, Deshmukh R, Said DG, Dua HS. Infectious keratitis: an update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance. Eye. 2021;35(4):1084-101.
Tang A, Marquart ME, Fratkin JD, Mc Cormick CC, Caballero AR, Gatlin HP, et al. Properties of PASP: A Pseudomonas Protease Capable of Mediating Corneal Erosions. Invest Ophthalmol Vis Sci. 2011;50(8): 3794-801.
Khurana AK, Khurana AK, Khurana B. Comprehensive ophthalmology. India: New Age Publishers; 2012.
Caballero AR. Bacterial keratitis. Community Eye Health J. 2010;1:13-8.
Keratitits. Available at: https://www.geekymedics. com/keratitis. Accessed on 20 November 2023.
Chang DC, Grant GB, O’Donnell K, Wannemuehler KA, Noble-Wang J, Rao CY, et al. Multistate outbreak of Fusarium keratitis associated with use of a contact lens solution external icon. JAMA. 2006; 296:953-63.
McCray E, Rampell N, Solomon SL, Bond WW, Martone WJ, O’Day D. Outbreak of Candida parapsilosis endophthalmitis after cataract extraction and intraocular lens implantation external icon. J Clin Microbiol. 1986;24:625-8.
Mikosz CA, Smith RM, Kim M, Tyson C, Lee EH, Adams E, et al. Fungal endophthalmitis associated with compounded products external icon. Emerg Infect Dis. 2014;20:248-56.
Thomas PA, Kaliamurthy J. Mycotic keratitis: epidemiology, diagnosis and management external icon. Clin Microbiol Infect. 2013;19:210-20.
Oude Lashof AM, Rothova A, Sobel JD, Ruhnke M, Pappas PG, Viscoli C, et al. Ocular manifestations of candidemia external icon. Clin Infect Dis. 2011;53(3): 262-8.
Sobel JD. Fungal keratitis. Community Eye Health J. 2011;1:21-5.
Epstein AB. In the aftermath of the Fusarium keratitis outbreak: What have we learned? Clin Ophthalmol. 2007;1(4):355-66.
Feldman BH. Fungal Keratitis. Available at: https://www.aao.org/Fungal_Keratitis. Accessed on 20 November 2023.
Lorenzo-Morales J, Khan NA, Walochnik J. An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment. Parasite. 2015;22:10.
Martín-Navarro M. The potential pathogenicity of chlorhexidine-sensitive Acanthamoeba strains isolated from contact lens cases from asymptomatic individuals in Tenerife, Canary Islands, Spain. J Med Microbiol. 2008;57(11):1399-404.
Sobel JD. Acanthamoeba keratitis Community Eye Health J. 2011;2:81-7.
Bacteria. Available at: https://www.my.cleveland clinic.org/health/articles/24494-bacteria. Accessed on 20 November 2023.
Harris SD. Branching of fungal hyphae: regulation, mechanisms and comparison with other branching systems. Mycologia. 2008;100(6):823-32.
Alexopoulos CJ, Mims CW, Blackwell M. Introductory Mycology. USA: John Wiley & Sons; 2012:30.
Deacon J. Fungal Biology. Massachusetts: Blackwell Publishers; 2005:31.
Chang S-T, Miles PG. Mushrooms: Cultivation, Nutritional Value, Medicinal Effect and Environmental Impact. Florida: CRC Press. 2021.
Fungus. Available at: https://www.en.m.wikibooks. org/wiki/File:Structure of fungus.jpg. Accessed on 20 November 2023.
Virus. Available at: https://www.my.clevelandclinic. org/health/body/24861-virus. Accessed on 20 November 2023.
Virus Structure. Available at: https://flexbooks.ck12. org/cbook/ck-12-advanced-biology/section/11.22/ primary/lesson/virus-structure-advanced-bio-adv. Accessed on 20 November 2023.
Ma SK, So K, Chung PH, Chuang SK. A multi-country outbreak of fungal keratitis associated with a brand of contact lens solution: the Hong Kong experience. Int J Infect Dis. 2009;13(4):443-8.
Durand ML. Endophthalmitis external icon. Clin Microbiol Infect. 2013;19(3):227-34.
Ibrahim MM, Vanini R, Ibrahim FM, Fioriti LS. Epidemiologic aspects and clinical outcome of fungal keratitis in southeastern Brazil. Eur J Ophthalmol. 2009;19(3):355-61.
Tuft S. How to manage herpes zoster ophthalmicus. Community Eye Health. 2020;33(108):71-2.
CDC Advisory. Available at: https://www.cdc.gov/ other/archived-content.html. Accessed on 20 November 2023.
Manisha S. Demographic details, risk factors, microbiological profile, and clinical outcomes of pediatric infectious keratitis cases in North India. Indian J Ophthalmol. 2020;68(3):434-40.
Chowdhary A. Spectrum of Fungal Keratitis in North India. Cornea. 2005;24(1):12-9.
Soleimani M, Tabatabaei SA, Mohammadi SS, Valipour N, Mirzaei A. A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center. J Ophthalmic Inflamm Infect. 2020;10(1):35.
Kanski JJ, Bowling B. Clinical Ophthalmology: A Systematic Approach. Edinburgh: Elsevier/Saunders; 2015.
Keratitis. Available at: https://www.wikipedia.org/ wiki/Keratitis. Accessed on 20 November 2023.
Wessely K. About anaphylactic phenomena of the cornea. Munchen Med Wehascher. 1911;58:1713.
Prakash G, Sharma N, Goel M, Titiyal JS, Vajpayee RB. Evaluation of intrastromal injection of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal keratitis. Am J Ophthalmol. 2008;146(1):56-9.
Thiel MA, Zinkernagel AS, Burhenne J, Kaufmann C, Haefeli WE. Voriconazole concentration in human aqueous humor and plasma during topical or combined topical and systemic administration for fungal keratitis. Antimicrob Agents Chemother. 2007; 51(1):239-44.
Bunya VY, Hammersmith KM, Rapuano CJ, Ayres BD, Cohen EJ. Topical and oral voriconazole in the treatment of fungal keratitis. Am J Ophthalmol. 2007; 143(1):151-3.