Keratomycosis: Etiology, Risk Factors and Differential Diagnosis- A Mini Review on Trichophyton spp

Abstract

Fungal keratitis is an infectious disease of the cornea. Lack of suspicion and delayed diagnosis herald the onset of complications often leading to permanent loss of vision or worse, enucleation. While a variety of pathogenic fungi especially non-dermatophyte molds associated with fungal keratitis have been identified, a comprehensive review identifying the Trichophyton spp. has not been completed. Trichophyton spp. is a rare but important entity implicated in fungal keratitis. Case reports from around the world designate it as a dangerous pathogen. Trichophyton spp. implicated in keratitis has not previously been reported and is considerably greater than suggested by incidence studies. Patient outcome is heavily reliant upon correct identification, timely intervention and effective treatment. Species identification, the risk factors associated with, and pathogenesis of keratitis will allow the development of improved therapies. This mini review provides a resource for clinicians and researchers to recognize Trichophyton spp. as a potent etiological agent capable of causing keratitis. It is no more a dermatophyte limited to infection of appendages.

Keywords: Corneal ulcer; Delhi; Trichophyton erinacei; Trichophyton rubrum.

[Table/Fig-1]:

Hypopyon in the right eye of patient no. 1

[Table/Fig-2]:

Photomicrograph of T.rubrum. note the pencil shaped macroconidia with abundant microconidia

[Table/Fig-3]:

T.erinacei characterized by its brilliant lemon yellow reverse pigment on sabouraud dextrose agar

[Table/Fig-4]:

Photomicrograph of T.erinacei. Microscopic features resemble T.rubrum with clavate/ tear drop shaped microconidia and large slender macroconidia