Colletotrichum keratitis in Mexico: Literature review

Abstract Introduction: Colletotrichum is a genus with species causing dermal superficial mycoses or keratitis. Objective: It is a retrospective, descriptive, and interventional serial patients study, made in an eye care hospital, trough 6½ years, describing nine cases of Colletotrichum keratitis, including diagnosis procedures, treatment, outcome, and literature review. Materials and Methods: Since first consultation, each patient was observed on the slit lamp for their keratitis clinical characteristics, considering their antecedent or risk factor. Over their clinical signs and symptoms, we made the diagnosis of infectious keratitis. For accurate diagnostic was taken two scraping cornea samples, one for smears; periodic acid-schiff and Gram stains and other for fungal and bacteria cultures. In eight cases, septate hyphae was observed and was administered antimycotic treatment, starting since the first consultation date. In subsequent visit, the medical treatment was adjusted in each patient and submitted to surgery if were needed. Results: Colletotrichum keratitis in our Cornea Service was found in 9/329 (2.7%) fungal keratitis, in smears was detected septate hyphae in 8/9 cases (88.8%). We lose to follow up two patients for treatment. Seven cases were followed for at least 8 months. Six cases had stable best-corrected final visual acuity after treatment. In one case had mixed fungal keratitis with Aspergillus glaucus , evolving to endophthalmitis and pthisis bulbi. Conclusion: Fungal keratitis caused by Colletotrichum has unpredictable progression. The good prognosis depends on the trauma antecedent, early and accurate diagnosis, Colletotrichum specie antimycotic susceptibility, right medical treatment, and surgery when it is needed.