Candida tropicalis Fungal Keratitis: A Case Report and Literature Review

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Abstract

Fungal keratitis, or keratomycosis, is an infection of the cornea caused by fungi. Although it is less frequently implicated in ocular infections than bacterial keratitis, its prognosis remains more guarded. However, the fungi involved include a variety of rare fungal species. Fungal keratitis caused by C. tropicalis has been reported only rarely in the literature.

We report the first case of Candida tropicalis corneal abscess diagnosed in the Parasitology-Mycology Department of the Hassan II University Hospital in Fez: a 66-year-old patient with corneal dystrophy was admitted to the Ophthalmology Department for management of a corneal abscess of the left eye. Fungal infection was confirmed by mycological study of the corneal scrapings. The patient was put on antifungal treatment with good clinical improvement.

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Endophthalmitis

Shwu-Jiuan Sheu (2017)

Endophthalmitis is a rare but severe form of ocular inflammation due to infection of the intraocular cavity that can lead to irreversible visual loss if not treated properly and timely. It can be classified as exogenous or endogenous based on the transmission route of the infectious source. Exogenous endophthalmitis occurs when infecting organisms gain entry into the eye via direct inoculation, while endogenous endophthalmitis occurs when infectious agents hematogenously spread into the eye from a distant focus of infection. The diagnosis of endophthalmitis depends mostly on the clinical findings on ophthalmological examination. Delayed diagnosis of endogenous endophthalmitis can lead to not only visual loss, but also increased risk of mortality. Since ocular and systemic symptoms of endophthalmitis are usually non-specific, early diagnosis relies on the alertness of clinicians. Early diagnosis and proper treatment are keys to saving the eye. Following advances in vitreoretinal pharmacotherapy and surgical technology, early surgical intervention is the current trend in the management of endophthalmitis.

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Production of biofilm by Candida and non-Candida spp. isolates causing fungemia: comparison of biomass production and metabolic activity and development of cut-off points.

Jesús Guinea, Laura Judith Marcos-Zambrano, Pilar Escribano … (2014)

Biofilm production in Candida spp. can be studied by measuring the biomass produced after application of crystal violet stain or by measuring metabolic activity with XTT. Our study is the first in which crystal violet and XTT are compared to analyze the ability of clinically relevant Candida and non-Candida species to produce biofilm. We studied 577 isolates causing fungemia in 512 patients admitted from January 2007 to July 2013. Based on the biomass production measured by crystal violet and the metabolic activity measured by XTT, strains were divided into terciles to establish tentative cut-offs to classify isolates as being low, moderate, or high biofilm-forming and as having low, moderate, or high metabolic activity. Considerable variability in biofilm production and metabolic activity was found both between species and within species. C. tropicalis showed the highest biomass production, whereas C. glabrata showed the highest metabolic activity, and non-Candida species isolates showed the lowest metabolic activity (P 0.2) and as low biofilm-forming, moderate biofilm-forming, and high biofilm-forming according to their cut-offs by crystal violet ( 1.17). The overall categorical agreement between the procedures was 43.7%, which increased to >50% for C. albicans and C. parapsilosis. XTT and crystal violet are complementary procedures for the study of biofilm production.

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Epidemiology, species distribution and in vitro antifungal susceptibility of fungaemia in a Spanish multicentre prospective survey.

Jesús Guinea, P. Merino, Miguel Porras … (2012)

To update the knowledge of the epidemiology of fungaemia episodes in Spain, the species implicated and their in vitro antifungal susceptibilities. Episodes were identified prospectively over 13 months at 44 hospitals. Molecular methods were used to determine the cryptic species inside the Candida parapsilosis and Candida glabrata complexes. Susceptibility to amphotericin B, anidulafungin, caspofungin, fluconazole, flucytosine, itraconazole, micafungin, posaconazole and voriconazole was determined by a microdilution colorimetric method. New species-specific clinical breakpoints (SSCBPs) for echinocandins, fluconazole and voriconazole were applied. The incidence of the 1357 fungaemia episodes evaluated was 0.92 per 1000 admissions. The incidence of Candida albicans fungaemia was the highest (0.41 episodes/1000 admissions), followed by Candida parapsilosis sensu stricto (0.22). Candida orthopsilosis was the fifth cause of fungaemia (0.02), outnumbered by Candida glabrata and Candida tropicalis. Interestingly, the incidence of fungaemia by C. parapsilosis was 11 and 74 times higher than that by C. orthopsilosis and Candida metapsilosis, respectively. Neither Candida nivariensis nor Candida bracarensis was isolated. Fungaemia was more common in non-intensive care unit settings (65.2%) and among elderly patients (46.4%), mixed fungaemia being incidental (1.5%). Overall susceptibility rates were 77.6% for itraconazole, 91.9% for fluconazole and 96.5%-99.8% for the other agents. Important resistance rates were only observed in C. glabrata for itraconazole (24.1%) and posaconazole (14.5%), and in Candida krusei for itraconazole (81.5%). Fungaemia is more common in non-critical patients. C. albicans is the most common species, followed by C. parapsilosis and C. glabrata. Nearly 90% of yeasts are susceptible to all antifungal agents tested. Resistance rates change moderately when applying the new SSCBPs.

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Author and article information

Journal

Journal ID (nlm-ta): Cureus

Journal ID (iso-abbrev): Cureus

Journal ID (issn): 2168-8184

Title: Cureus

Publisher: Cureus (Palo Alto (CA) )

ISSN (Electronic): 2168-8184

Publication date (Electronic, pub): 19 June 2024

Publication date (Electronic, collection): June 2024

Volume: 16

Issue: 6

Electronic Location Identifier: e62682

Affiliations

[1 ] Parasitology and Mycology Department, Central Laboratory of Medical Analyses, Hassan II University Hospital Center/Faculty of Medicine, Pharmacy and Dentistry, Sidi Med Ben Abdellah University, Fez, MAR

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Soukaina Adadi soukaina.adadi@ 123456usmba.ac.ma

Article

DOI: 10.7759/cureus.62682

PMC ID: 11258954

PubMed ID: 39036143

SO-VID: 77ccd269-d8a0-4b24-9c32-a6f3130dd3be

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This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Candida tropicalis Fungal Keratitis: A Case Report and Literature Review

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Decoding Infection and Transmission

Most cited references 17

Endophthalmitis

Production of biofilm by Candida and non-Candida spp. isolates causing fungemia: comparison of biomass production and metabolic activity and development of cut-off points.

Epidemiology, species distribution and in vitro antifungal susceptibility of fungaemia in a Spanish multicentre prospective survey.

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