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FUNGUS EYE DISEASE Blepharitis Keratitis POHS Endophthalmitis Orbital disease
Fungal Blepharitis Rare 1.Dermatophytes 2.Candida Poorly controlled DM
Fungal Keratitis 1.Fusarium (65%- tropics) 2.Candida (12.5%) 3.Curvularia (9%) 4.Aspergillus (4%- temperate) A) Filamentous Keratitis (Asp., Fusarium) TRAUMA by organic matter (wood)/ Rural No preexisting eye disease or immunosupression Grayish-white ulcer (indistinct, elevated margins) Feathery stromal infiltrates/ ring infiltrate Satellite lesions/ hypopyon
B) Candida Keratitis Chronic eye disease Immunocompromised Yellow-white ulcer Dense suppuration Management: Reculture/ deep scrapings/ corneal biopsy Exclude fungal dacryocystitis Debridement (daily for 1/52) Topical LONG 6/52 min (Natamycin- imidazole) Systemic (sleral involvement)/ itrakonazole PRK (25%)
POHS Histoplasma capsulatum/ Airborne Missisipi- Misouri river valleys (5-10%) Majority : asymptomatic fungaemia (URTI) Small minority: severe, disseminated (endophthalmitis)/ immunocompromised POHS Investigations: Skin test: 90% ve + XR: calcification (lung, liver, spleen) HLA -B7 (maculopathy)
Symptoms/ Signs: Asymptomatic unless maculopathy (metamorphopsia) 1.Atrophic histo-spots (immunologic reaction) 2.PPA 3.Peripheral linear streaks (chorioretinal atrophy) 4.CNV (20-45y)/ 5-10% 5.NO Vit. involvement Daily Amsler chart fellow eye if unilat. maculopathy with asymptomatic histospot in fellow eye Rx: Argon laser after FFA
Endophthalmitis A) Fusarium/ Asp.: rapid visual loss Exogenous: surgery, trauma, keratitis B) C. albicans/ opportunistic: Slow progression/ well tolerated Endogenous: 1.Drug addicts (SKIN) 2.Catheters (iv hyperalimentation) 3.Immunocompromised
Choroidal focus retinal invasion (Roth spots) vitreous (cotton ball) string of pearls endophthalmitis (retinal necrosis) vit. organisation (traction RD) Rx: 5 FC+ Ketokonazole (3/52) iv amphotericin TPPV + intravit amphot 30% candidemia: candidiasis 80% candidiasis: chorioretinitis 85% endogenous endophth.: disseminated candidiasis
Fungal endophthalmitis following cataract surgery Rare (Western World- late presentation) Cluster infections (within 4/52) Developing countries (20%-India, isolated, early diffuse presentation) Aspergilus flavus Rx: TPPV+ antifungal agents Visual outcome: corneal involvement NO STEROIDS
Orbital Disease Aspergillus species Immunocompetent host (usually) Immunosupressed (sinoorbital aspergillosis) 1.Allergic fungal sinusitis (non-invasive/ children) 2.Invasive fungal sinusitis (tropics, Sudan) Slow, painless extension from sinuses to orbit and brain (months) High mortality: 80% Rx: surgery+ antifungal agents
MUCORMYCOSIS Opportunistic phycomycetes (Mucorales) 1.DK 2.MA/ uremia 3.Severe immunosuppression 4.Desferrioxamine Vascular occlusion- infarction- necrosis Sinusitis, pharyngitis, nasal discharge Multiple cranial nerve palsies CRAO Eschar (periorbital,nose, hard palate) LATE
Rx: PROMPT and AGGRESSIVE Metabolic deficit Surgical Amphotericin B (iv, locally) Hyperbaric oxygen
OPPORTUNISTIC FUNGAL INFECTIONS Smilja Kalenic, MD, PhD Clinical Hospital Centre Zagreb, Croatia.
Systemic fungal infection (Mycosis). Candidiasis candida albicans infection Immune compromised Pt. 1.Skin and M.M. candidiasis 2.Ophthalmic C. loss.
Fungal Diseases of Paranasal Sinuses. Classification Non invasive fungal rhinosinusitis. –Allergic fungal rhinosinusitis –Mycetoma Invasive fungal rhinosinusitis.
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Incidence and outcomes of Pigmented versus Nonpigmented fungal keratitis - A Retrospective analysis Dr. Thiruvengada Krishnan, M.D. Aravind Eye Hospital.
FUNGAL DISEASES IN THE RESPIRATORY , EXCRETORY & CIRCULATORY SYSTEMS
Fungal Sinusitis: An Overview Cade Martin, MD. Fungal Sinusitis 400,000 known fungal species or which 400 are human pathogens and 50 of which cause systemic.
Acute and Chronic visual loss By Dr. ABDULMAJID ALSHEHAH Ophthalmology consultant Anterior Segment and Uveitis consultant.
Mycology Lec,7 Opportunistic mycosis Dr.Huda Ibrahim.
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Respiratory Fungal Infections Dr. Ahmed Albarrag School of Medicine and the University Hospitals King Saud University.
Dr. A.Aziz Djamal MSc.DTM&H.SpMK(K ). 1. Cosmopolitant : Aspergillus, Candida and Cryptococcosis. 2. Exotic type : In a specific area Penicillium marneffei.
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Fungal infections Lobna AL Juffali,Msc. Introduction Primary or “pathogenic” fungi that can cause disease in both healthy and immunocompromised individuals.
Fungal infections 400 out of 75,000 Primary infections Opportunistic infections Myco-toxins Allergy.
FUNGAL KERATITIS IN MAN Andrew Tullo Royal Eye Hospital, Manchester.
VISUAL LOSS IN THE ELDERLY. Aetiology Sudden –Retinal Retinal vascular occlusion Wet AMD –Neurological AION Neurological visual field loss Gradual –Cataract.
Fungal Diseases March 24 th, Fungi fundamentals Occupy almost every ecological niche Exist in two forms: Yeasts –Single celled Molds –Growth in.
Management of Mycotic Keratitis Chief author: Sudesh Kumar Arya Chief author: Sudesh Kumar Arya Co-authors: Anamika Garg Jagdish Chander Jagdish Chander.
MICROBIOLOGY JEOPARDY Third Nine Weeks 2014 ElDoradoHighSchoolAZTECS
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A IRBORNE I NFECTION. A IRBORNE INFECTIONS : Contracted by inhalation of microorganisms or spores suspended in air on water droplets or dust particles.
Brain Abscess. What is brain abscess? Focal collection within brain parenchyma.
OPPORTUNISTIC MYCOSES Sevtap Arikan, MD. OPPORTUNISTIC MYCOSES General features CAUSATIVE AGENTS Saprophyte in nature/found in normal flora HOST Immunosupressed.
Deep fungal disease Parasitosis and Deep fungal disease Tian Dong Ping 田东萍 Dept. of Pathology Shantou University Medical College.
neoformans causes cryptococcal meningitis. C neoformans is an oval, budding yeast surrounded by a wide polysaccharide.
Beyond bacteria and viruses……. u Diverse group of heterotrophs. Many are ecologically important saprophytes (consume dead and decaying matter) Others.
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Sclera/Episclera, Uvea/Iris, Vitreous, & Glaucoma.
Brain Abscess Dr. Safdar Malik. Definition Brain abscess is a focal suppurative infection within the brain parenchyma, typically surrounded by a vascularized.
Dalia Kamal Eldien Mohammed. The main subcutaneous fungal infections include: Mycetoma Chromoblastomycosis Sporotrichosis Lobomycosis Rhinosporidiosis.
Fungal Sinusitis: A Call for a Better Understanding Hail M. Al-Abdely, MD Consultant, Infectious Diseases.
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Cornea Dr. Chandrakanth. Transparent, avascular, Watch glass- like Anterior 1/6 th of outer fibrous coat Elliptical [dia. H( ~11.5mm )>V( ~11mm )] K-value:
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Aspergillus Aspergillus is a filamentous, hyaline mold. It can grow on dead leaves, stored grain, and other decaying vegetation. Large numbers of.
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