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Knutsson KA, Rama P, Tombolini B, Di Biase C, Senni C, Buffoli F, Clementi N, Tonelli M, Carletti S, Mancini N, Ferrari G, Paganoni G, Bandello F. Beauveria bassiana Keratitis: A Case Series and Review of Literature. J Clin Med 2023; 12:7601. [PMID: 38137670 PMCID: PMC10744012 DOI: 10.3390/jcm12247601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/25/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Beauveria bassiana is a filamentous fungus commonly used as an insecticide that rarely causes keratitis. METHODS Patients affected by Beauveria bassiana keratitis were retrospectively recruited at San Raffaele Hospital (Milan, Italy) between 2020 and 2022. All subjects underwent comprehensive ophthalmic evaluation, including in vivo confocal microscopy (IVCM) and microbiologic examination of corneal scrapings. Beauveria bassiana was identified using 18S rDNA targeted PCR. RESULTS Four eyes of four patients (51 ± 8.8 years old) were evaluated. The main risk factors were soft contact lens wear (75%) and trauma with vegetative matter (50%). A superficial infiltrate was displayed in the majority of patients. Three cases (75%) showed hyphae on IVCM. All patients showed clinical improvement after topical antifungal therapy, although mostly through a combination of two antifungals (75%). One patient with a deeper infection required a systemic antifungal agent after one month of topical therapy. All cases required debridement to reduce the microbial load and enhance drug penetration. All patients experienced keratitis resolution following medical treatment (average: 3.3 months). CONCLUSIONS The identification of risk factors and the early diagnosis of Beauveria bassiana keratitis are fundamental in order to avoid its penetration in the deeper corneal stromal layers. Topical antifungal drugs, possibly accompanied by ulcer debridement, may be a successful treatment if instilled from the early phases of the disease.
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Affiliation(s)
- Karl Anders Knutsson
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (B.T.); (C.S.); (G.F.); (G.P.); (F.B.)
| | - Paolo Rama
- University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (P.R.); (C.D.B.)
| | - Beatrice Tombolini
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (B.T.); (C.S.); (G.F.); (G.P.); (F.B.)
| | - Carlo Di Biase
- University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (P.R.); (C.D.B.)
| | - Carlotta Senni
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (B.T.); (C.S.); (G.F.); (G.P.); (F.B.)
| | - Fabio Buffoli
- Laboratory of Medical Microbiology and Virology, University Vita-Salute San Raffaele, 20132 Milan, Italy; (F.B.); (N.C.); (S.C.)
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, University Vita-Salute San Raffaele, 20132 Milan, Italy; (F.B.); (N.C.); (S.C.)
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Marco Tonelli
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Silvia Carletti
- Laboratory of Medical Microbiology and Virology, University Vita-Salute San Raffaele, 20132 Milan, Italy; (F.B.); (N.C.); (S.C.)
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, University of Insubria, 21100 Varese, Italy;
| | - Giulio Ferrari
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (B.T.); (C.S.); (G.F.); (G.P.); (F.B.)
| | - Giorgio Paganoni
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (B.T.); (C.S.); (G.F.); (G.P.); (F.B.)
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (B.T.); (C.S.); (G.F.); (G.P.); (F.B.)
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Host and Environmental Sensing by Entomopathogenic Fungi to Infect Hosts. CURRENT CLINICAL MICROBIOLOGY REPORTS 2022. [DOI: 10.1007/s40588-022-00185-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brunner-Mendoza C, Guerrero-Guerra C, Villagómez-Figueroa O, Navarro-Barranco H, Pérez-Mejía A, Toriello C. A review of described cases of mycotic keratitis and sclerokeratitis related to entomopathogenic fungi from 1984 to 2021. J Mycol Med 2022; 32:101249. [DOI: 10.1016/j.mycmed.2022.101249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
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