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Mycopathologia

, Volume 182, Issue 3–4, pp 379–385 | Cite as

Aspergillus flavus Keratitis: Experience of a Tertiary Eye Clinic in Turkey

  • Elif Erdem
  • Meltem Yagmur
  • Hazal Boral
  • Macit Ilkit
  • Reha Ersoz
  • Seyedmojtaba Seyedmousavi
Article

Abstract

We investigated the clinical and mycological characteristics of four cases of mycotic keratitis caused by Aspergillus flavus that occurred from July 2014 to May 2015 at Çukurova University Hospital, Adana, Turkey. In a 10-month period, a total of 64 corneal smear/scrapings were examined from patients with suspected mycotic keratitis. Fungal cultures were positive in six of these patients, indicating a 9.4% incidence of mycotic keratitis in this region, including four cases of A. flavus and two cases of Fusarium spp. The predisposing factors, clinical presentation, and success of the therapeutic approaches were further evaluated. For all cases, topical voriconazole was the first choice of treatment. Surgical procedures were required to control infection in 3 of the 4 cases, including intrastromal voriconazole injection for two cases and keratoplasty for one case. Predisposing factors included trauma (two cases, 50%), contact lens use (one case, 25%), and previous ocular surgery (one case, 25%). The clinical presentations also differed, including a well-limited ulcer (one case), an ulcer with an irregular feathery margin (one case), and ulcers with satellite lesions (two cases). The mean duration between the time of presentation and definitive diagnosis by culture was 14 days (8–25 days). We observed that A. flavus keratitis can present with different underlying factors and clinical conditions. A combination of antifungal therapy and supportive surgical intervention may resolve infections caused by A. flavus in the cornea.

Keywords

Aspergillus flavus Mycotic keratitis Voriconazole 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Elif Erdem
    • 1
  • Meltem Yagmur
    • 1
  • Hazal Boral
    • 2
  • Macit Ilkit
    • 2
  • Reha Ersoz
    • 1
  • Seyedmojtaba Seyedmousavi
    • 3
    • 4
    • 5
  1. 1.Department of Ophthalmology, Faculty of MedicineUniversity of ÇukurovaAdanaTurkey
  2. 2.Division of Mycology, Department of Microbiology, Faculty of MedicineUniversity of ÇukurovaAdanaTurkey
  3. 3.Department of Medical MicrobiologyRadboud UMCNijmegenThe Netherlands
  4. 4.Invasive Fungi Research CenterMazandaran University of Medical SciencesSariIran
  5. 5.Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaUSA

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