There are several taxonomic systems available for identifying Fusarium species. The philosophy used in each taxonomic system is discussed as well as problems encountered in working with Fusarium species in culture. Fusarium species are toxigenic, and the mycotoxins produced by these organisms are often associated with animal and human diseases. The implications for the association of the carcinogens, fumonisins, produced by Fusarium moniliforme and other Fusarium species with human diseases are discussed. Foreign-body-associated fusarial infection such as keratitis in contact lens wearers, onychomycosis, skin infections, and disseminated multiorgan infections are discussed. Disseminated fusarial hyalohyphomycosis has emerged as a significant, usually fatal infection in the immunocompromised host. Successful outcome is determined by the degree of immunosuppression, the extent of the infection, and the presence of a removable focus such as an indwelling central venous catheter. These infections may be clinically suspected on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy, probably with one of the newer antifungal agents. Perhaps the use of such agents or the use of colony-stimulating factors may improve the outcome of this devastating infection. However, until new approaches for treatment develop, effective preventive measures are urgently needed.

Taxonomy, biology, and clinical aspects of Fusarium species.

Pathogenesis of microbial keratitis

Risk factors, clinical features, and outcomes of recurrent fungal keratitis after corneal transplantation.

The fungal pathogens Fusarium solani and Fusarium oxysporum cause severe corneal disease in the United States and worldwide and were the causative organisms in a recent outbreak of contact lens-associated keratitis. To characterize innate immunity in Fusarium keratitis, we developed a murine model in which conidia are injected into the corneal stroma. Immunocompetent C57BL/6 mice rapidly developed severe corneal opacification associated with neutrophil infiltration and clearance of Fusarium hyphae. In contrast, neutrophil infiltration was delayed in MyD88−/− mice, resulting in uncontrolled growth of Fusarium hyphae in the corneal stroma and anterior chamber, and eventually resulting in corneal perforation. Corneal opacification scores in TLR2−/−, TLR4−/−, and TLR2/4−/− mice were similar to those of C57BL/6 mice; however, TLR4−/− and TLR2/4−/− mice had impaired antifungal responses. The phenotype of infected IL-1R1−/− mice was similar to that of MyD88−/− mice, with uncontrolled fungal growth resulting in corneal perforation. IL-1R1−/− mice also produced significantly less CXCL1/KC in the corneal stroma compared with C57BL/6 mice consistent with delayed neutrophil recruitment to the corneal stroma. Together, these findings indicate that IL-1R1 and MyD88 regulate CXC chemokine production and neutrophil recruitment to the cornea, and that TLR4 has an important role in controlling growth and replication of these pathogenic fungi.

/pdf/myd88-regulation-of-fusarium-keratitis-is-dependent-on-tlr4-3ay1ebh0jz.pdf

MyD88 Regulation of Fusarium Keratitis Is Dependent on TLR4 and IL-1R1 but Not TLR2

The Role of Cytokines and Pathogen Recognition Molecules in Fungal Keratitis – insights from human disease and animal models

Electron microscopic observations, as well as in vitro experiments, on experimental Fusarium solani keratitis of rabbits were performed to study the mode of fungal invasion into the corneal stroma, the interactions between F. solani and inflammatory cells under the influence of topical dexamethasone (DXM) treatment, and the survival mechanism of the fungi in the DXM-treated cornea. Electron microscopy showed that, while the fungus invaded into the corneal stroma, digestion of collagen fibrils occurred around the hyphae, where amorphous material was often noted. In DXM-nontreated cornea, the fungal hyphae were entrapped by pseudopodia of the neutrophils and destruction of the hyphae was noted on day 3 of infection, most hyphae having disappeared by day 7. In the DXM-treated cornea, however, neutrophils could not ingest and destroy the hyphae. In qualitative nitroblue tetrazolium (NBT)-reduction tests using rabbit peripheral blood neutrophils, DXM significantly suppressed the rate of NBT-reduction and the r...

Invasion and survival of Fusarium solani in the dexamethasone-treated cornea of rabbits.

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Invasion and survival of Fusarium solani in the dexamethasone-treated cornea of rabbits.