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30 Cards in this Set
- Front
- Back
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list three predisposing factors for a fungal infection
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trauma especially with egeetable matter (EWCL),
immunosuppression improper use of steroids |
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fungi are seperated into two main catagories what are they?
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filamentous multi-cellular and non filamentous uni-cellular
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what fungi is the most virulent and rapidly destructive in the filamentous multicellular fungi?
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fusarium, it exists in warmer regions
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what are the three main filamentous multicellular fungi tht infect normal eyes that have sustained damage?
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fusarium (warmer regions)
aspergillus (warmer regions) cephalosporiium - more indolent |
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what is the main nonfilamentous unicellular fungi (yeast)/ that causes opportunistic keratitis in compromised corneas?
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candida (colder regions)
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fusarium is a major corneal pathogen in what part of the united states
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southern where it is warmer
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the B and L fungal outbreak was due to what type of fungi?
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fusarium
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one of the filamentous fungi is commonly found in indoor air, which one?
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aspergillus
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what type of filamentous fungus commonly takes advantage of immunocompromised individuals
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cephalosporium
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what fungus is commonly found on inanimate objects, food, and hospital environments
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candida
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what fungus is the most common pathogenic cause for fungal endogenous endophthalmitis?
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candida
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you see a stromal grey-white opacity with elevation, that has indistinct feathery margins. Also present is hypopyon. what could it be?
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fungal keratitis by a filamentous species like fusarium, if it was caused by a nonfilamentous species the opacity would be more yellow-grey and denser like a bacterial infection
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is the epithelium in tact or not with a fungal keratitis infection
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yes but it raised so it will show neg staining with flourocine
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what must you DDx a fungal keratitis from?
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bacterial keratitis/ ulcer. bacterial is not as feathery appearing but could still have hypopyon.
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what is the only topical ocular drug available in the US for fungal infection?
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natamycin 5%
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what is the drug and dosage used for filamentous fungal keratitis
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natamycin 5%, q1h even during sleep then taper slowly over weeks.
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what is the treatment and dosage for nonfiamentous fungal keratitis
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amphotericin B .15% q5min x 1 hour then q1h
daily debridement required |
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general guidlines for treating fungal infections
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NO STEROIDS
tell the pt they will be on medication for months consider hospitalization refer to corneal special keratoplasty may be needed contact instructionsw |
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what are the main systemic fungal drugs?
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flucytoysine PO, or topical sln
keoconazole PO |
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what are some risk factors for acanthamoeba
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any event that disrupts the epitheium
CL's, homemade sln FB non- sterile water. (resistant to chlorine) co-infection with HSV or bacterial keratitis |
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acanthamoeba uses protolytic enzymes to attack what?
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keratocyes
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what are the steps to corneal infection by acanthamoeba?
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compromised corneal epi
invasion of stroma loss of keratocytes inflammation stromal vecrosis |
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what are the symptoms of acanthamoeba infection
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severe pain
unilateral red eye photophobia blurry vision waxing and waning of symptoms |
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what are the signs of early, late(3-8 weeks), and other signs of acanthamoeba?
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early: PEE's, limbitis
late: stromal ring infiltrate, radial keratoneuritis (enlarged corneal nerves =pathoneumonic) and anterior uveitis with hypopyon other: corneal microcysts, bullous keratopathy, disciform stromal keratitis, stromal necrosis--> corneal perforation |
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DDx for acanthamoeba
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HSV, fungal keratitis, and bacterial keratitis
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why is acanthamoeba laid on e coli to grow in the lab
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it eats it. yum yum
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what can be used for confocal microscopy in vivo of the cornea in the office?
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the HRT because if you dont have one you are not cool.
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how do you treat acanthamoeba?
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no consensus, there are no commercially available agents some that are used are chlorhexadine, polyhexamethylene, propamidine, or brolene/PHMB
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what does waxing and waning refer to in an acanthamoeba infection?
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if you are treating say a co-existant bacterial or viral infection the acanthamoeba will go into cyst for and appear like it is not there anymore then when you let off of the drugs it will come back
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on a side note what do you prescribe for an HSV infection
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triflurodine
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