:: Volume 35, Issue 3 (Fall 2025) ::
MEDICAL SCIENCES 2025, 35(3): 377-381 Back to browse issues page
A rare case of corneal ulcer caused by pythium insidiosum diagnosed with PCR screening and DNA sequencing: a case report
Mehran Zarei-Ghanavati1 , Mehrnaz Atighehchian2 , Zakieh Vahedian2 , Fatemeh Bazvand2 , Seyed Mehdi Tabatabaei2 , Esmaeil Asadi Khameneh12
1- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran , mehran_zarei@yahoo.com
2- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (1829 Views)
This report discusses a case involving infectious corneal ulcers in a 32-year-old pregnant woman. The clinical presentation of keratitis did not align with the typical signs of fungal keratitis. Initial investigations, including corneal scraping for smear and culture samples, showed no evidence of fungal infection, leading to the start of topical antibacterial treatment. Despite this, there was still a concern about a fungal infection, which led to repeat sampling. Unfortunately, the patient's condition progressed, even after the application of topical antifungal medications. This progression resulted in an intraocular infection known as endophthalmitis. Due to the inability to manage the infection effectively, the affected eye was ultimately eviscerated. Further evaluation, including advanced diagnostic techniques like polymerase chain reaction, showed that the cause of the infection was a rare quasi-fungal organism called Pythium insidiosum
Keywords: Keratitis, Corneal ulcer, Polymerase chain reaction, Pythium insidiosum.
Full-Text [PDF 910 kb]   (636 Downloads)    
Semi-pilot: Case Report | Subject: Ophtalmology
Received: 2024/12/30 | Accepted: 2025/03/12 | Published: 2025/09/1
References
1. Soltani Shahgoli S, Cheraqpour K, Soleimani M, Atighehchian M, Tabatabaei SA, Sargolzaeimoghaddam M, ET AL. Post-laser refractive surgery keratitis: A concise narrative review. J Int Med Res 2023;51:3000605231206054.
2. Awad R, Ghaith AA, Awad K, Mamdouh Saad M, Elmassry AA. Fungal Keratitis: Diagnosis, Management, and Recent Advances. Clin Ophthalmol 2024;18:85-106. [DOI:10.2147/OPTH.S447138]
3. Gurnani B, Kaur K, Venugopal A, Srinivasan B, Bagga B, Iyer G, et al. Pythium insidiosum keratitis - A review. Indian J Ophthalmol 2022;70:1107-20. [DOI:10.4103/ijo.IJO_1534_21]
4. Gurnani B, Kaur K, Agarwal S, Lalgudi VG, Shekhawat NS, Venugopal A, et al. Pythium insidiosum Keratitis: Past, Present, and Future. Ophthalmol Ther 2022;11:1629-53. [DOI:10.1007/s40123-022-00542-7]
5. Atighehchian M, Latifi A, Nozarian Z, Amoli FA, Zarei-Ghanavati M. Fungal keratitis complicating the diagnosis of Acanthamoeba keratitis. Med Mycol Case Rep 2024;47:100687. [DOI:10.1016/j.mmcr.2024.100687]
6. Kammarnjesadakul P, Palaga T, Sritunyalucksana K, Mendoza L, Krajaejun T, Vanittanakom N, et al. Phylogenetic analysis of Pythium insidiosum Thai strains using cytochrome oxidase II (COX II) DNA coding sequences and internal transcribed spacer regions (ITS). Med Mycol 2011;49:289-95. [DOI:10.3109/13693786.2010.511282]
7. Sridapan T, Krajaejun T. Nucleic Acid-Based Detection of Pythium insidiosum: A Systematic Review. J Fungi (Basel) 2022;9:27. [DOI:10.3390/jof9010027]
8. Schurko AM, Mendoza L, Lévesque CA, Désaulniers NL, de Cock AW, Klassen GR. A molecular phylogeny of Pythium insidiosum. Mycol Res 2003;107:537-44. [DOI:10.1017/S0953756203007718]
9. Vishwakarma P, Bagga B. Pythium insidiosum keratitis: Review of literature of 5 years' clinical experience at a tertiary eye care center. Semin Ophthalmol 2023;38:190-200. [DOI:10.1080/08820538.2022.2116287]
10. Bagga B, Sharma S, Madhuri Guda SJ, Nagpal R, Joseph J, Manjulatha K, et al. Leap forward in the treatment of Pythium insidiosum keratitis. Br J Ophthalmol 2018;102:1629-33. [DOI:10.1136/bjophthalmol-2017-311360]
11. Bagga B, Kate A, Mohamed A, Sharma S, Das S, Mitra S. Successful Strategic Management of Pythium insidiosum Keratitis with Antibiotics. Ophthalmology 2021;128:169-72. [DOI:10.1016/j.ophtha.2020.05.046]
12. Gurnani B, Kaur K. Anti-infective therapies for Pythium insidiosum keratitis. Expert Rev Anti Infect Ther 2024;22:805-17. [DOI:10.1080/14787210.2024.2403146]
13. Atighehchian M, Ghassemi H, Latifi G, Ouano D, Abedinifar Z, Zarei-Ghanavati M. Topical Caspofungin 0.5% Monotherapy for Filamentous Fungal Keratitis. Cornea 2025. [DOI:10.1097/ICO.0000000000003790]

XML   Persian Abstract   Print

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 35, Issue 3 (Fall 2025) Back to browse issues page