Corneal fungal disease in small animals

Acremonium and trichosporon fungal keratoconjunctivitis in a Leopard Gecko (Eublepharis macularius)

A 6-year-old male leopard gecko (Eublepharis macularius) was presented with a 2-year history of recurrent dysecdysis involving the ocular surface of both eyes. Ophthalmic examination revealed ocular surface desiccation and multifocal superficial ulcerative keratitis with patchy remnants of retained shed. Other abnormalities included stomatitis and mandibular and maxillary osteomyelitis. Topical and systemic antibiotic therapy, oral vitamin A, and improved husbandry conditions resolved the stomatitis and osteomyelitis but did not improve the ocular surface. Corneal cytology collected with a cytobrush revealed branching hyphae and budding yeast consistent with fungal keratitis. Fungal culture grew Acremonium sp. and Trichosporon sp. The addition of topical antifungal therapy improved the ocular surface health, but the patient was euthanized 7 weeks after initial presentation for persistent vomiting and dyspnea. Necropsy was declined. This case describes the first case of fungal keratitis caused by Acremonium sp. and Trichosporon sp. in a reptile.

Keratomycosis in five dogs

Five cases of canine keratomycosis were diagnosed and treated at a private Veterinary Ophthalmology Practice in Melbourne, Australia. Clinical presentations varied between dogs. Predisposing factors were identified in 4 of 5 cases. Diagnostic modalities utilized were corneal cytology and fungal culture. Corneal cytology confirmed the presence of fungal organisms in all five cases. Aspergillus, Scedosporium, and Candida were cultured from three cases, respectively. Specific antifungal treatment included 1% voriconazole solution or 1% itraconazole ointment. Keratectomy and conjunctival grafting surgery was performed in two patients. Resolution of infection and preservation of vision were achieved in 4 of 5 patients.

Canine keratomycosis in 11 dogs: a case series (2000-2011)

Keratomycosis is rarely reported in dogs. The purpose of this study was to review the signalment, clinical characteristics, predisposing factors, and outcome of 11 cases of canine keratomycosis. Medical records of included dogs were reviewed and follow-up information was obtained by re-examination of patients following their initial diagnosis. All 11 patients possessed predisposing factors for fungal keratitis, including an underlying endocrinopathy, pre-existing corneal disease, intraocular surgery, and/or prolonged use of either topical antibiotics or corticosteroids at the time of initial examination. Diagnostic techniques included corneal cytology demonstrating yeast or hyphae in 6 of 11 eyes, and fungal cultures with positive results in 7 of 11 eyes. Fungal organisms isolated included Cladosporium spp. (n = 1), Chrysosporium spp. (n = 1), Curvularia spp. (n = 2), Aspergillus spp. (n = 1), Penicillium spp. (n = 1), and Phialemonium spp. (n = 1). Of the 11 patients, 6 responded to medical management alone. Two resolved after a superficial keratectomy, and three were enucleated due to either endophthalmitis or progression of corneal disease. This study identified potential risk factors for developing fungal keratitis.

Treatment of dematiaceous fungal keratitis in a dog

CASE DESCRIPTION

A 9-year-old castrated male Bichon Frise was evaluated because of a 3-week history of a nonhealing corneal ulcer and corneal pigmentation of the left eye.

CLINICAL FINDINGS

Ophthalmic examination of the left eye revealed conjunctival hyperemia, corneal neovascularization, corneal edema, corneal ulceration, and central corneal pigmentation. Intraocular structures of the left eye could not be visually examined because of the diffuse nature of the corneal lesions. The right eye had anterior cortical incipient cataracts, nuclear sclerosis, and an inactive chorioretinal scar.

TREATMENT AND OUTCOME

Superficial lamellar keratectomy of the left eye was performed for both therapeutic and diagnostic purposes. Histologic evaluation of corneal biopsy specimens revealed dematiaceous fungal keratitis of the left eye, and topical administration of voriconazole was used to successfully resolve the keratitis. Seven months after diagnosis of dematiaceous fungal keratitis, the dog had no clinical signs or history of recurrence of the keratitis.

CLINICAL RELEVANCE

Dematiaceous fungal keratitis should be considered as a possible cause of nonhealing corneal ulceration with heavy pigment deposition in dogs. Results suggested that lamellar keratectomy along with topical administration of voriconazole can be used successfully to treat dematiaceous fungal keratitis in dogs.

Optimal management of equine keratomycosis

Keratomycosis in the horse exists in several unique clinical forms. This paper discusses the diagnosis and clinical management of keratomycosis in the horse associated with tear film instability, epithelial keratopathy, subepithelial infiltrates, superficial and deep ulcers, plaques, melting ulcers, descemetoceles, iris prolapse, and stromal abscesses. Prompt diagnosis and aggressive treatment of equine keratomycosis can make a major difference in the maintenance of a cosmetic and visual eye.