Ocular pythiosis: is it under-diagnosed?

Am J Ophthalmol. 2004 Feb;137(2):370-2. doi: 10.1016/S0002-9394(03)00908-5.

Abstract

Purpose: To increase awareness of ocular pythiosis by presenting a typical case and summarizing clinical data of 11 ocular pythiosis cases in Ramathibodi Hospital.

Design: Interventional case report.

Methods: A 48-year-old healthy woman with a history of 3-week painful corneal ulcer of left eye was treated with enucleation.

Results: The histopathology of enucleated eye revealed endophthalmitis and ulcerative keratitis with numerous hyphae in full-thickness of corneal stroma. The culture identification of the causative organism was Pythium insidiosum. The final diagnosis was ocular pythiosis.

Conclusions: Pythium insidiosum is a causative agent of pythiosis and is distributed worldwide. Ocular pythiosis may not be uncommon, as it may be underdiagnosed due to unfamiliarity among clinicians and microbiologists. Diagnosis of pythiosis is difficult. The disease has high morbidity, as evidenced by nearly evisceration or enucleation among all patients at Ramathibodi Hospital. Early detection and effective treatment are needed for possible cure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Corneal Stroma / microbiology*
  • Corneal Stroma / pathology
  • Corneal Ulcer / diagnosis*
  • Corneal Ulcer / microbiology
  • Corneal Ulcer / surgery
  • Eye Enucleation
  • Eye Infections, Fungal / diagnosis*
  • Eye Infections, Fungal / microbiology
  • Eye Infections, Fungal / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycoses / diagnosis*
  • Mycoses / microbiology
  • Mycoses / surgery
  • Pythium / isolation & purification*