Overview
Mycotic keratitis caused by Fusarium species is an infectious corneal ulceration often associated with environmental exposure to Fusarium mycotoxins, leading to significant ocular morbidity 1.Diagnosis
Clinical presentation includes corneal ulceration with characteristic Fusarium hyphae on microscopy 1.
Culture of corneal scrapings is essential for definitive diagnosis 1.
Histopathology may reveal fungal elements and tissue necrosis 1.Management
First-line treatment typically involves topical antifungals such as natamycin 5% ophthalmic suspension 1.
Adjunctive therapy may include fortified topical antifungals like voriconazole 1% ophthalmic solution 1.
Surgical intervention like corneal debridement or grafting may be necessary in severe cases 1.Special Populations
Pregnancy: No specific data provided in the abstracts 12.
Pediatrics: No specific data provided in the abstracts 12.
Elderly: No specific data provided in the abstracts 12.
Comorbidities: Chronic exposure to mycotoxins (e.g., T-2 toxin) may predispose individuals to opportunistic infections, including mycotic keratitis 1.Key Recommendations
Perform corneal scrapings and cultures for definitive diagnosis of Fusarium keratitis (Evidence: Moderate 1).
Initiate treatment with topical natamycin 5% ophthalmic suspension as first-line therapy (Evidence: Moderate 1).
Consider adjunctive voriconazole 1% ophthalmic solution for refractory cases (Evidence: Moderate 1).
Monitor for and manage potential opportunistic infections in immunocompromised or chronically exposed individuals (Evidence: Expert opinion 1).References
1 Ferreras MC, Benavides J, García-Pariente C, Delgado L, Fuertes M, Muñoz M et al.. Acute and chronic disease associated with naturally occurring T-2 mycotoxicosis in sheep. Journal of comparative pathology 2013. link
2 Dacasto M, Rolando P, Nachtmann C, Ceppa L, Nebbia C. Zearalenone mycotoxicosis in piglets suckling sows fed contaminated grain. Veterinary and human toxicology 1995. link