Journal Article

Fusarium Keratitis: A Systematic Review (1969 to 2023)

Al-Hatmi, Abdullah M. S., da Silva Dantas, Maryanna, Bastos, Rafael Wesley, Cintra, Maria Eduarda Carvalho, Rossato, Luana

2024

Overview

Background Mycotic keratitis (MK) represents a corneal infection, with Fusarium species identified as the leading cause. Fusarium is a genus of filamentous fungi commonly found in soil and plants. While many Fusarium species are harmless, some can cause serious infections in humans and animals, particularly Fusarium keratitis, that can lead to severe ocular infections, prevalent cause of monocular blindness in tropical and subtropical regions of the world. Due to its incidence and importance in ophthalmology, we conducted a systematic analysis of clinical cases to increase our understanding of Fusarium keratitis by gathering clinical and demographic data. Methods To conduct an analysis of Fusarium keratitis, we looked through the literature from the databases PubMed, Embase, Lilacs, and Google Scholar and found 99 papers that, between March 1969 and September 2023, corresponded to 163 cases of Fusarium keratitis. Results Our analysis revealed the Fusarium solani species complex as the predominant isolate, with females disproportionately affected by Fusarium keratitis. Notably, contact lens usage emerged as a significant risk factor, implicated in nearly half of cases. Diagnosis primarily relied on culture, while treatment predominantly involved topical natamycin, amphotericin B, and/or voriconazole. Surprisingly, our findings demonstrated a prevalence of cases originating from the United States, suggesting potential underreporting and underestimation of this mycosis in tropical regions. This shows the imperative for heightened vigilance, particularly in underdeveloped regions with substantial agricultural activity, where Fusarium infections may be more prevalent than currently reported. Conclusion Our study sheds light on the clinical complexities of Fusarium keratitis and emphasizes the need for further research and surveillance to effectively tackle this vision-threatening condition. Furthermore, a timely identification and early initiation of antifungal treatment appear to be as important as the choice of initial treatment itself.

• Publisher: Springer Netherlands,Springer,Springer Nature B.V
• Subject: Amphotericin B / Amphotericin B - therapeutic use / Analysis / Antifungal agents / Antifungal Agents - therapeutic use / Antiparasitic agents / Biomedical and Life Sciences / Blindness / Caspofungin / Contact Lenses - adverse effects / Contact Lenses - microbiology / Cornea / Eukaryotic Microbiology / Eye Infections, Fungal - diagnosis / Eye Infections, Fungal - drug therapy / Eye Infections, Fungal - epidemiology / Eye Infections, Fungal - microbiology / Fungi / Fusariosis - diagnosis / Fusariosis - drug therapy / Fusariosis - epidemiology / Fusariosis - microbiology / Fusarium / Fusarium - genetics / Fusarium - isolation & purification / Health aspects / Humans / Infection / Infections / Keratitis / Keratitis - diagnosis / Keratitis - drug therapy / Keratitis - epidemiology / Keratitis - microbiology / Life Sciences / Medical Microbiology / Microbial Ecology / Microbiology / Mycoses / Mycosis / Natamycin / Natamycin - therapeutic use / Ophthalmology / Plant Sciences / Posaconazole / Prevalence / Review / Risk Factors / Soil microorganisms / Tropical environment / Vigilance / Voriconazole / Voriconazole - therapeutic use