Fungal keratitis due to Scopulariopsis brevicaulis and a potential promising therapeutic effect of antibacterial agents

Purpose To evaluate the therapeutic effect of incorporating continuous administration of voriconazole in the treatment of recalcitrant fungal keratitis. Methods In this prospective case study, 5 consecutive patients (5 eyes) with fungal keratitis were treated with a standard protocol after the failing maximal conventional medical treatment. The protocol involved continuous lavage of the ulcer with 1% voriconazole through an irrigator for 2 h, twice a day, combined with local and systemic antifungals. Visual acuity, slit lamp findings of the ulcer, and fungal hyphae density by confocal microscope were documented, respectively. Results In 4 patients, the clinical symptoms and slit lamp examination were significantly improved after only 3 days of treatment. The hyphae were shown to decrease in number and morphologically fragmented in corneal stroma by confocal microscopy. After the infection was controlled, 2 cases required further keratoplasty. In one case, the treatment was deemed ineffective and a conjunctival flap had to be created to help control the infection. In all 5 patients, the best spectacle-corrected visual acuity had improved after treatment. With more than 3 months of follow-up, no recurrence of infection was seen in any cases. Conclusion Our treatment protocol demonstrated improvement in the treatment of clinically resistant fungal keratitis. Continuous lavage of voriconazole is easy to be implemented and well-tolerated by patients. Modification of the current protocol should be further explored to optimize the therapeutic effectiveness in future.

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Therapeutic Effect of Corneal Crosslinking on Fungal Keratitis: Efficacy of Corneal Collagen Crosslinking as an Adjuvant Therapy for Fungal Keratitis in a Tertiary Eye Hospital in South India

Ocular Immunology and Inflammation ◽

10.1080/09273948.2020.1770296 ◽

2020 ◽

pp. 1-8

Author(s):

Vimalin Jeyalatha Mani ◽

Durgadevi Parthasarathy ◽

Prema Padmanabhan ◽

Niveditha Narayanan ◽

Meena Lakshmipathy ◽

...

Keyword(s):

Adjuvant Therapy ◽

Therapeutic Effect ◽

South India ◽

Fungal Keratitis ◽

Collagen Crosslinking ◽

Corneal Crosslinking ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

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Role of intrastromal vancomycin in recalcitrant corneal abscess after phacoemulsification

BMJ Case Reports ◽

10.1136/bcr-2021-241709 ◽

2021 ◽

Vol 14 (5) ◽

pp. e241709

Author(s):

Mohit Chhabra ◽

Ruchi Goel ◽

Samreen Khanam ◽

Sonam Singh

Keyword(s):

Antibacterial Agents ◽

Antifungal Agents ◽

Anterior Segment ◽

Pharmacokinetic Profile ◽

Fungal Keratitis ◽

Hygiene Practices ◽

Topical Antibacterial ◽

Port Infection ◽

Side Port

Side port infection and corneal abscess after cataract surgery can produce devastating outcomes. Topical antibacterial drugs are the mainstay in management of these cases. Although intrastromal antifungal agents are an established modality for fungal keratitis, such use of antibacterial agents is rarely reported due to better pharmacokinetic profile of antibacterial agents.We report a case of methicillin-resistant Staphylococcus aureus corneal abscess following phacoemulsification that responded to intrastromal vancomycin injection in addition to conventional therapy.This case of postphacoemulsification corneal abscess highlights the importance of postoperative hygiene practices, use of anterior segment optical coherence tomography for monitoring these patients and use of intrastromal vancomycin as an adjunct to topical and systemic therapy.

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Fungal keratitis caused by Scopulariopsis brevicaulis: successful treatment with topical amphotericin B and chloramphenicol without the need for surgical debridement.

British Journal of Ophthalmology ◽

10.1136/bjo.78.9.730 ◽

1994 ◽

Vol 78 (9) ◽

pp. 730-730 ◽

Cited By ~ 19

Author(s):

A J Lotery ◽

J R Kerr ◽

B A Page

Keyword(s):

Amphotericin B ◽

Successful Treatment ◽

Fungal Keratitis ◽

Surgical Debridement ◽

Scopulariopsis Brevicaulis

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APPLICATION OF GALVANOENTEROSORPTION IN MULTIMODAL TREATMENT OF PATIENTS WITH THERMAL BURNS

Kharkiv Surgical School ◽

10.37699/2308-7005.2.2021.15 ◽

2021 ◽

pp. 80-84

Author(s):

O. Y. Khomko ◽

B. V. Petryuk ◽

L. P. Khomko ◽

G. I. Sydorchuk ◽

T. A. Petryuk ◽

...

Keyword(s):

Blood Plasma ◽

Therapeutic Effect ◽

Fibrinolytic Activity ◽

Multimodal Treatment ◽

Antibacterial Agents ◽

Traditional Treatment ◽

Thermal Burns ◽

Integrated Therapy ◽

Combined Use ◽

High Level

Abstract. Aim – to investigate the influence of enterosorption and its combination with intra-tissue electrophoresis (ITE) of antibacterial preparations on the proteolytic and fibrinolytic activity of blood plasma in patients with common thermal burns. Material and methods. Enterosorbtion detoxification by enterosgel was used in the multimodal treatment of 28 patients with thermal burns of II-IV stages. The drug was prescribed from 2-3 days after burn for 7-14 days, depending on the severity of the injury and manifestations of the intoxication syndrome. In 24 patients the treatment was complemented by galvanization of burn wounds with the preliminary introduction of antibacterial drugs. ITE began with 3-4 days after burn, taking into account the sensitivity of the microflora to antibiotics. The comparison group was made up of 30 patients with similar areas and depths of thermal burns receiving traditional treatment. Results and discussion. It was discovered that the inclusion of enterosorption in multimodal therapy of burns diminished the level of unlimited proteolysis, favoured the increase of the level of blood plasma fibrinolytic activity. Its combination with ITE of antibacterial agents (galvanoenterosorption) ensured a higher therapeutic effect. Common deep thermal burns are accompanied by a significant increase in proteolytic and fibrinolytic activity (FA) of blood. Inclusion of enterosorbtion in the integrated therapy of burns provides reduction of proteolytic activity and maintenance of a high level of FA of plasma, which reduces the risk of thromboembolic complications. Conclusion. Combined use of enterosorption and ITE of antibacterial agents (galvanoentersorption) with thermal burns provides a higher therapeutic effect.

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Enhancing the antibacterial activity of antimicrobial peptide PMAP-37(F34-R) by cholesterol modification

BMC Veterinary Research ◽

10.1186/s12917-020-02630-x ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Liangliang Chen ◽

Tengfei Shen ◽

Yongqing Liu ◽

Jiangfei Zhou ◽

Shuaibing Shi ◽

...

Keyword(s):

Antibacterial Activity ◽

Antimicrobial Peptide ◽

Therapeutic Effect ◽

Antibacterial Agents ◽

Antimicrobial Agents ◽

Therapeutic Effects ◽

Microbial Infection ◽

Cholesterol Modification

Abstract Background The problem of increasing resistance against conventional antibiotics has drawn people’s attention. Therefore, the development of novel antibacterial agents with effective and safe therapeutic effects is imminent. Antimicrobial peptides (AMPs) are considered a promising class of antibacterial agents due to their broad antibacterial spectrum. Results In this study, on the basis of our previously studied peptide PMAP-37(F34-R), a novel antimicrobial peptide Chol-37(F34-R) was developed by N-terminal cholesterol modification to increase hydrophobicity. We observed that the N-terminal cholesterol-modified Chol-37(F34-R) showed higher antimicrobial activity than PMAP-37(F34-R) in vitro. Chol-37(F34-R) also exhibited effective anti-biofilm activity and may kill bacteria by improving the permeability of their membranes. Chol-37(F34-R) exerted high stability in different pH, salt, serum, and boiling water environments. Chol-37(F34-R) also showed no hemolytic activity and substantially low toxicity. Furthermore, Chol-37(F34-R) exhibited good potency of bacteria eradication and promoted wound healing and abscess reduction in infected mice. Meanwhile, in S. aureus ATCC25923-infected peritonitis model, Chol-37(F34-R) exhibited an impressive therapeutic effect by reducing the decrease in systemic bacterial burden and alleviating organ damage. Conclusions Our findings suggested that the N-terminal cholesterol modification of PMAP-37(F34-R) could improve antibacterial activity. Chol-37(F34-R) displayed excellent bactericidal efficacy and impressive therapeutic effect in vivo. Thus, Chol-37(F34-R) may be a candidate for antimicrobial agents against microbial infection in the clinic.

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