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1.
Segal BH, 2009. Aspergillosis. N Engl J Med 360: 1870–1884.
-
2.
Badiee P, Alborzi A, Nejabat M, 2011. Detection of Aspergillus keratitis in ocular infections by culture and molecular method. Int Ophthalmol 31: 291–296.
-
3.
Krishnan S, Manavathu EK, Chandrasekar PH, 2009. Aspergillus flavus: an emerging non-fumigatus Aspergillus species of significance. Mycoses 52: 206–222.
-
4.
Khairallah SH, Byrne KA, Tabbara KF, 1992. Fungal keratitis in Saudi Arabia. Doc Ophthalmol 79: 269–276.
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5.
Jackson WB, 2008. Blepharitis: current strategies for diagnosis and management. Can J Ophthalmol 43: 170–179.
-
6.
Dalmon C, Porco TC, Lietman TM, Prajna NV, Prajna L, Das MR, Kumar JA, Mascarenhas J, Margolis TP, Whitcher JP, Jeng BH, Keenan JD, Chan MF, McLeod SD, Acharya NR, 2012. The clinical differentiation of bacterial and fungal keratitis: a photographic survey. Invest Ophthalmol Vis Sci 53: 1787–1791.
-
7.
Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN, 2002. The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in south India. Cornea 21: 555–559.
-
8.
Vilela RC, Vilela L, Vilela P, Vilela R, Motta R, Pôssa AP, de Almeida C, Mendoza L, 2014. Etiological agents of fungal endophthalmitis: diagnosis and management. Int Ophthalmol 34: 707–721.
-
9.
McCulley JP, Shine WE, 2000. Changing concepts in the diagnosis and management of blepharitis. Cornea 19: 650–658.
-
10.
Seal DV, McGill JI, Jacobs P, Liakos GM, Goulding NJ, 1985. Microbial and immunological investigations of chronic non-ulcerative blepharitis and meibomianitis. Br J Ophthalmol 69: 604–611.
-
11.
Sridhar MS, Gopinathan U, Rao GN, 2003. Fungal keratitis associated with vernal keratoconjunctivitis. Cornea 22: 80–81.
-
12.
Al-Badriyeh D, Neoh CF, Stewart K, Kong DC, 2010. Clinical utility of voriconazole eye drops in ophthalmic fungal keratitis. Clin Ophthalmol 4: 391–405.
-
13.
Mehta H, Mehta HB, Garg P, Kodial H, 2008. Voriconazole for the treatment of refractory Aspergillus fumigatus keratitis. Indian J Ophthalmol 56: 243–245.
-
14.
O'Day DM, Head WS, Robinson RD, Clanton JA, 1986. Corneal penetration of topical amphotericin B and natamycin. Curr Eye Res 5: 877–882.
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Recurrent Fungal Keratitis and Blepharitis Caused by Aspergillus flavus
Chia-Yi Lee
Chia-Yi Lee
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan.
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Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan.
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Yi-Ju Ho
Yi-Ju Ho
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Chi-Chin Sun
Chi-Chin Sun
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Hsin-Chiung Lin
Hsin-Chiung Lin
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Ching-Hsi Hsiao
Ching-Hsi Hsiao
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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David Hui-Kang Ma
David Hui-Kang Ma
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Chi-Chun Lai
Chi-Chun Lai
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Hung-Chi Chen
Hung-Chi Chen
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Aspergillus species produces a wide spectrum of fungal diseases like endophthalmitis and fungal keratitis ophthalmologically, but there has been no report about blepharitis caused by Aspergilus flavus to date. Herein, we report a 61-year-old ethnic Han Taiwanese male who had suffered from pain with burning and foreign body sensation after an insect bite on his left eye. Specimens from bilateral eyelids suggested infection of A. flavus, whereas corneal scraping showed the presence of Gram-negative bacteria. He was admitted for treatment of infectious keratitis with topical antibiotic and antifungal eye drops. Two weeks after discharge, recurrent blepharitis and keratitis of A. flavus was diagnosed microbiologically. Another treatment course of antifungal agent was resumed in the following 6 months, without further significant symptoms in the following 2 years. Collectively, it is possible for A. flavus to induce concurrent keratitis and blepharitis, and combined treatment of keratitis as well as blepharitis is advocated for as long as 6 months to ensure no recurrence.
Author Notes
Financial support: This study was supported by the Chang Gung Memorial Hospital (CMRPG3D0901, CMRPG3E0931, and CMRPG3F1471) and the Ministry of Science and Technology (MOST 104-2314-B-182A-007) in Taiwan to Hung-Chi Chen.
Authors' addresses: Chia-Yi Lee, Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan, and Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan, E-mail: ao6u.3msn@hotmail.com. Yi-Ju Ho, Hsin-Chiung Lin, Ching-Hsi Hsiao, David Hui-Kang Ma, Chi-Chun Lai, and Hung-Chi Chen, Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan, E-mails: freedomshield3800@gmail.com, hsinchiung@gmail.com, hsiao.chinghsi@gmail.com, davidhkma@yahoo.com, chichun.lai@gmail.com, and mr3756@cgmh.org.tw. Chi-Chin Sun, Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan, E-mail: arvin.sun@msa.hinet.net.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Segal BH, 2009. Aspergillosis. N Engl J Med 360: 1870–1884.
-
2.
Badiee P, Alborzi A, Nejabat M, 2011. Detection of Aspergillus keratitis in ocular infections by culture and molecular method. Int Ophthalmol 31: 291–296.
-
3.
Krishnan S, Manavathu EK, Chandrasekar PH, 2009. Aspergillus flavus: an emerging non-fumigatus Aspergillus species of significance. Mycoses 52: 206–222.
-
4.
Khairallah SH, Byrne KA, Tabbara KF, 1992. Fungal keratitis in Saudi Arabia. Doc Ophthalmol 79: 269–276.
-
5.
Jackson WB, 2008. Blepharitis: current strategies for diagnosis and management. Can J Ophthalmol 43: 170–179.
-
6.
Dalmon C, Porco TC, Lietman TM, Prajna NV, Prajna L, Das MR, Kumar JA, Mascarenhas J, Margolis TP, Whitcher JP, Jeng BH, Keenan JD, Chan MF, McLeod SD, Acharya NR, 2012. The clinical differentiation of bacterial and fungal keratitis: a photographic survey. Invest Ophthalmol Vis Sci 53: 1787–1791.
-
7.
Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN, 2002. The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in south India. Cornea 21: 555–559.
-
8.
Vilela RC, Vilela L, Vilela P, Vilela R, Motta R, Pôssa AP, de Almeida C, Mendoza L, 2014. Etiological agents of fungal endophthalmitis: diagnosis and management. Int Ophthalmol 34: 707–721.
-
9.
McCulley JP, Shine WE, 2000. Changing concepts in the diagnosis and management of blepharitis. Cornea 19: 650–658.
-
10.
Seal DV, McGill JI, Jacobs P, Liakos GM, Goulding NJ, 1985. Microbial and immunological investigations of chronic non-ulcerative blepharitis and meibomianitis. Br J Ophthalmol 69: 604–611.
-
11.
Sridhar MS, Gopinathan U, Rao GN, 2003. Fungal keratitis associated with vernal keratoconjunctivitis. Cornea 22: 80–81.
-
12.
Al-Badriyeh D, Neoh CF, Stewart K, Kong DC, 2010. Clinical utility of voriconazole eye drops in ophthalmic fungal keratitis. Clin Ophthalmol 4: 391–405.
-
13.
Mehta H, Mehta HB, Garg P, Kodial H, 2008. Voriconazole for the treatment of refractory Aspergillus fumigatus keratitis. Indian J Ophthalmol 56: 243–245.
-
14.
O'Day DM, Head WS, Robinson RD, Clanton JA, 1986. Corneal penetration of topical amphotericin B and natamycin. Curr Eye Res 5: 877–882.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2073 | 1842 | 73 |
| Full Text Views | 435 | 11 | 0 |
| PDF Downloads | 205 | 12 | 0 |