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-
1.
Lerksuthirat T , Sangcakul A , Lohnoo T , Yingyong W , Rujirawat T , Krajaejun T , 2017. Evolution of the sterol biosynthetic pathway of Pythium insidiosum and related oomycetes contributes to antifungal drug resistance. Antimicrob Agents Chemother 61: e02352-16.
-
2.
Sharma S , Balne PK , Motukupally SR , Das S , Garg P , Sahu SK , Arunasri K , Manjulatha K , Mishra DK , Shivaji S , 2015. Pythium insidiosum keratitis. Cornea 34: 438–442.
-
3.
Hasika R , Lalitha P , Radhakrishnan N , Rameshkumar G , Prajna NV , Srinivasan M , 2019. Pythium keratitis in South India: incidence, clinical profile, management, and treatment recommendation. Indian J Ophthalmol 67: 42–47.
-
4.
Bagga B , Kate A , Mohamed A , Sharma S , Das S , Mitra S , 2021. Successful strategic management of Pythium insidiosum keratitis with antibiotics. Ophthalmology 128: 169–172.
-
5.
Vishwakarma P , Mohanty A , Kaur A , Das S , Priyadarshini SR , Mitra S , Mittal R , Sahu SK , 2021. Pythium keratitis: clinical profile, laboratory diagnosis, treatment, and histopathology features post-treatment at a tertiary eye care center in eastern India. Indian J Ophthalmol 69: 1544–1552.
-
6.
Bagga B , Sharma S , Madhuri Guda SJ , Nagpal R , Joseph J , Manjulatha K , Mohamed A , Garg P , 2018. Leap forward in the treatment of Pythium insidiosum keratitis. Br J Ophthalmol 102: 1629–1633.
-
7.
Thanathanee O , Enkvetchakul O , Rangsin R , Waraasawapati S , Samerpitak K , Suwan-apichon O , 2013. Outbreak of Pythium keratitis during rainy season: a case series. Cornea 32: 199–204.
-
8.
Permpalung N , Worasilchai N , Manothummetha K , Torvorapanit P , Ratanawongphaibul K , Chuleerarux N , Plongla R , Chindamporn A , 2019. Clinical outcomes in ocular pythiosis patients treated with a combination therapy protocol in Thailand: a prospective study. Med Mycol 57: 923–928.
-
9.
Lelievre L , Borderie V , Garcia-Hermoso D , Brignier AC , Sterkers M , Chaumeil C , Lortholary O , Lanternier F , 2015. Imported Pythium insidiosum keratitis after a swim in Thailand by a contact lens-wearing traveler. Am J Trop Med Hyg 92: 270–273.
-
10.
Reinprayoon U , Permpalung N , Kasetsuwan N , Plongla R , Mendoza L , Chindamporn A , 2013. Lagenidium sp. ocular infection mimicking ocular pythiosis. J Clin Microbiol 51: 2778–2780.
-
11.
Mittal R , Jena S , Desai A , Agarwal S , 2017. Pythium insidiosum keratitis: histopathology and rapid novel diagnostic staining technique. Cornea 36: 1124–1132.
-
12.
Gurnani B et al.2022. Pythium insidiosum keratitis—a review. Indian J Ophthalmol 70: 1107.
-
13.
Rathi A et al.2018. Pythium keratitis leading to fatal cavernous sinus thrombophlebitis. Cornea 37: 519–522.
-
14.
Puangsricharern V , Chotikkakamthorn P , Tulvatana W , Kittipibul T , Chantaren P , Reinprayoon U , Kasetsuwan N , Satitpitakul V , Worasilchai N , Chindamporn A , 2021. Clinical characteristics, histopathology, and treatment outcomes of Pythium keratitis: a retrospective cohort study. Clin Ophthalmol 15: 1691–1701.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 2118 | 795 | 42 |
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Case Report: Poor Outcome Despite Aggressive Management in Pythium insidiosum Endophthalmitis
David Aggarwal
David Aggarwal
Anant Bajaj Retina Institute, L V Prasad Eye Institute (LVPEI), Hyderabad, India;
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Sanchita Mitra
Sanchita Mitra
Jhaveri Microbiology Centre, LVPEI, Hyderabad, India;
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Paavan Kalra
Paavan Kalra
The Cornea Institute, LVPEI, Hyderabad, India;
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Bhupesh Bagga
Bhupesh Bagga
The Cornea Institute, LVPEI, Hyderabad, India;
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Dilip Mishra
Dilip Mishra
Department of Ophthalmic Pathology Laboratory, LVPEI, Hyderabad, India;
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Brijesh Takkar
Brijesh Takkar
Anant Bajaj Retina Institute, L V Prasad Eye Institute (LVPEI), Hyderabad, India;
Indian Health Outcomes, Public Health, and Economics Research Centre, LVPEI, Hyderabad, India
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Indian Health Outcomes, Public Health, and Economics Research Centre, LVPEI, Hyderabad, India
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ABSTRACT.
Pythium insidiosum is a parasitic oomycete that can cause keratitis and closely resembles fungus, both clinically and morphologically. It requires a trained microbiologist for its differentiation from fungal filaments and has poor response to antifungal therapy. We present a case of primary isolation of the organism from the vitreous cavity in a case of endophthalmitis. The infection spread quickly and involved all the ocular tissues. The eye had poor visual outcome despite a sequence of rapidly completed retinal and corneal surgeries along with initiation of anti-Pythium therapy.
Author Notes
Financial support: All authors were supported by the Hyderabad Eye Research Foundation, Hyderabad, India. B. T. was supported by a Department of Biotechnology Wellcome Trust India Alliance Clinical Research Centre grant awarded to the IHOPE Centre (grant number IA/CRC/19/1/610010).
Authors’ addresses: David Aggarwal, Anant Bajaj Retina Institute, L V Prasad Eye Institute (LVPEI), Hyderabad, India, E-mail: davidaggarwal@gmail.com. Sanchita Mitra, Jhaveri Microbiology Center, LVPEI, Hyderabad, India, E-mail: sanchita.mitra@lvpei.org. Paavan Kalra and Bhupesh Bagga, The Cornea Institute, LVPEI, Hyderabad, India, E-mails: paavankalra@gmail.com and bhupesh@lvpei.org. Dilip Mishra, Department of Ophthalmic Pathology Laboratory, LVPEI, Hyderabad, India, E-mail: dilipkumarmishra@lvpei.org. Brijesh Takkar, Anant Bajaj Retina Institute, LVPEI, Hyderabad, India, and Indian Health Outcomes, Public Health, and Economics Research Centre, LVPEI, Hyderabad, India, E-mail: britak.aiims@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
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-
1.
Lerksuthirat T , Sangcakul A , Lohnoo T , Yingyong W , Rujirawat T , Krajaejun T , 2017. Evolution of the sterol biosynthetic pathway of Pythium insidiosum and related oomycetes contributes to antifungal drug resistance. Antimicrob Agents Chemother 61: e02352-16.
-
2.
Sharma S , Balne PK , Motukupally SR , Das S , Garg P , Sahu SK , Arunasri K , Manjulatha K , Mishra DK , Shivaji S , 2015. Pythium insidiosum keratitis. Cornea 34: 438–442.
-
3.
Hasika R , Lalitha P , Radhakrishnan N , Rameshkumar G , Prajna NV , Srinivasan M , 2019. Pythium keratitis in South India: incidence, clinical profile, management, and treatment recommendation. Indian J Ophthalmol 67: 42–47.
-
4.
Bagga B , Kate A , Mohamed A , Sharma S , Das S , Mitra S , 2021. Successful strategic management of Pythium insidiosum keratitis with antibiotics. Ophthalmology 128: 169–172.
-
5.
Vishwakarma P , Mohanty A , Kaur A , Das S , Priyadarshini SR , Mitra S , Mittal R , Sahu SK , 2021. Pythium keratitis: clinical profile, laboratory diagnosis, treatment, and histopathology features post-treatment at a tertiary eye care center in eastern India. Indian J Ophthalmol 69: 1544–1552.
-
6.
Bagga B , Sharma S , Madhuri Guda SJ , Nagpal R , Joseph J , Manjulatha K , Mohamed A , Garg P , 2018. Leap forward in the treatment of Pythium insidiosum keratitis. Br J Ophthalmol 102: 1629–1633.
-
7.
Thanathanee O , Enkvetchakul O , Rangsin R , Waraasawapati S , Samerpitak K , Suwan-apichon O , 2013. Outbreak of Pythium keratitis during rainy season: a case series. Cornea 32: 199–204.
-
8.
Permpalung N , Worasilchai N , Manothummetha K , Torvorapanit P , Ratanawongphaibul K , Chuleerarux N , Plongla R , Chindamporn A , 2019. Clinical outcomes in ocular pythiosis patients treated with a combination therapy protocol in Thailand: a prospective study. Med Mycol 57: 923–928.
-
9.
Lelievre L , Borderie V , Garcia-Hermoso D , Brignier AC , Sterkers M , Chaumeil C , Lortholary O , Lanternier F , 2015. Imported Pythium insidiosum keratitis after a swim in Thailand by a contact lens-wearing traveler. Am J Trop Med Hyg 92: 270–273.
-
10.
Reinprayoon U , Permpalung N , Kasetsuwan N , Plongla R , Mendoza L , Chindamporn A , 2013. Lagenidium sp. ocular infection mimicking ocular pythiosis. J Clin Microbiol 51: 2778–2780.
-
11.
Mittal R , Jena S , Desai A , Agarwal S , 2017. Pythium insidiosum keratitis: histopathology and rapid novel diagnostic staining technique. Cornea 36: 1124–1132.
-
12.
Gurnani B et al.2022. Pythium insidiosum keratitis—a review. Indian J Ophthalmol 70: 1107.
-
13.
Rathi A et al.2018. Pythium keratitis leading to fatal cavernous sinus thrombophlebitis. Cornea 37: 519–522.
-
14.
Puangsricharern V , Chotikkakamthorn P , Tulvatana W , Kittipibul T , Chantaren P , Reinprayoon U , Kasetsuwan N , Satitpitakul V , Worasilchai N , Chindamporn A , 2021. Clinical characteristics, histopathology, and treatment outcomes of Pythium keratitis: a retrospective cohort study. Clin Ophthalmol 15: 1691–1701.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2118 | 795 | 42 |
| Full Text Views | 382 | 27 | 0 |
| PDF Downloads | 157 | 27 | 0 |