{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:02:23Z","timestamp":1793397743056,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>\n                      The aim of this work was to study the demographic profile, clinical diagnostic features, challenges in management, treatment outcomes, and ocular morbidity of microbiological culture-proven\n                      <jats:italic toggle=\"yes\">Pythium keratitis<\/jats:italic>\n                      in a tertiary eye care hospital in South India.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Retrospective analysis of microbiologically proven\n                      <jats:italic toggle=\"yes\">Pythium keratitis<\/jats:italic>\n                      patients was performed at a tertiary eye center from October 2017 to March 2020. Demographic details, risk factors, microbiological investigations, clinical course, and visual outcomes were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirty patients were analyzed. The mean age was 43.1\u00b117.2 years. Most common risk factors were history of injury in 80% and exposure to dirty water in 23.3%. Visual acuity at baseline was 20\/30 to perception of light (PL). The most common clinical presentation was stromal infiltrate and hypopyon in 14 (46.6%) patients each. The microbiological confirmation was based on culture on blood agar and vesicles with zoospores formation with incubated leaf carnation method. Seven (23.3%) patients improved with topical 0.2% Linezolid and topical 1% Azithromycin, 19 (63.3%) patients underwent Therapeutic keratoplasty (TPK) and 4 were lost to follow-up. Seven (23.3%) patients had graft reinfection, and 3 (10%) developed endophthalmitis. The final visual acuity was 20\/20- 20\/200 in 6 (20%) patients, 20\/240-20\/1200 in 5 (16.6%) patients, hand movement to positive perception of light in 16 patients and no perception of light (Pthisis Bulbi) in 3 (10%) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">P. insidiosum keratitis<\/jats:italic>\n                      is a rapidly progressive infectious keratitis with prolonged and relapsing clinical course. It usually results in irreparable vision loss in majority of the patients. Prompt diagnosis, clinical awareness, and specific treatment options are needed for successfully managing this devastating corneal disease.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1808_20","type":"journal-article","created":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T11:32:28Z","timestamp":1619955148000},"page":"1095-1101","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":43,"title":["Retrospective multifactorial analysis of Pythium keratitis and review of literature"],"prefix":"10.4103","volume":"69","author":[{"given":"Bharat","family":"Gurnani","sequence":"first","affiliation":[{"name":"Cornea and Refractive Surgery Services, Cuddalore Main Road, Thavalukuppam, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Christy","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Surgery Services, Cuddalore Main Road, Thavalukuppam, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivananda","family":"Narayana","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Surgery Services, Cuddalore Main Road, Thavalukuppam, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purushothama","family":"Rajkumar","sequence":"additional","affiliation":[{"name":"Cornea and Refractive Surgery Services, Cuddalore Main Road, Thavalukuppam, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirandeep","family":"Kaur","sequence":"additional","affiliation":[{"name":"Pediatric Ophthalmology and Squint Fellow, Cuddalore Main Road, Thavalukuppam, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Gubert","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Cuddalore Main Road, Thavalukuppam, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"key":"B1-20240828","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4103\/ijo.IJO_445_18","article-title":"Pythium keratitis in South India:Incidence, clinical profile, management, and treatment recommendation","volume":"67","author":"Hasika","year":"2019","journal-title":"Indian J Ophthalmol"},{"key":"B2-20240828","doi-asserted-by":"crossref","first-page":"270","DOI":"10.4269\/ajtmh.14-0380","article-title":"Imported pythium insidiosum keratitis after a swim in Thailand by a contact lens-wearing traveler","volume":"92","author":"Lelievre","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"B3-20240828","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/j.1442-9071.2009.02135.x","article-title":"Pythium insidiosum keratitis in an Australian child","volume":"37","author":"Badenoch","year":"2009","journal-title":"Clin Exp Ophthalmol"},{"key":"B4-20240828","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/ICL.0b013e3182043114","article-title":"Pythium insidiosum keratitis in Israel","volume":"37","author":"Tanhehco","year":"2011","journal-title":"Eye Contact Lens"},{"key":"B5-20240828","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1136\/bjophthalmol-2017-311360","article-title":"Leap forward in the treatment of Pythium insidiosum keratitis","volume":"102","author":"Bagga","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"B6-20240828","doi-asserted-by":"crossref","first-page":"982","DOI":"10.12659\/AJCR.901158","article-title":"Diagnosis and treatment of pythium insidiosum corneal ulcer in a Chinese child:A case report and literature review","volume":"17","author":"He","year":"2016","journal-title":"Am J Case Rep"},{"key":"B7-20240828","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1097\/ICO.0000000000000349","article-title":"Pythium insidiosum keratitis:Clinical profile and role of DNA sequencing and zoospore formation in diagnosis","volume":"34","author":"Sharma","year":"2015","journal-title":"Cornea"},{"key":"B8-20240828","doi-asserted-by":"crossref","first-page":"7534","DOI":"10.1128\/AAC.02680-13","article-title":"New insights into the in vitro susceptibility of Pythium insidiosum","volume":"58","author":"Loreto","year":"2014","journal-title":"Antimicrob Agents Chemother"},{"key":"B9-20240828","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/13693780500279882","article-title":"Immunology and immunotherapy of the infections caused by Pythium insidiosum","volume":"43","author":"Mendoza","year":"2005","journal-title":"Med Mycol"},{"key":"B10-20240828","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1136\/bjophthalmol-2017-311804","article-title":"Clinical profile, risk factors and outcome of medical, surgical and adjunct interventions in patients with Pythium insidiosum keratitis","volume":"103","author":"Agarwal","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"B11-20240828","first-page":"801","article-title":"Human Pythiosis:Emergence of Fungal-Like Organism","volume":"185","author":"Permpalung","year":"2020","journal-title":"Mycopathologia"},{"key":"B12-20240828","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/ICO.0000000000001162","article-title":"Successful medical management of presumptive Pythium insidiosum keratitis","volume":"36","author":"Ramappa","year":"2017","journal-title":"Cornea"},{"key":"B13-20240828","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1600-0560.1993.tb00654.x","article-title":"Human subcutaneous pythiosis","volume":"20","author":"Triscott","year":"1993","journal-title":"J Cutan Pathol"},{"key":"B14-20240828","doi-asserted-by":"crossref","first-page":"234","DOI":"10.2310\/6670.2008.00073","article-title":"Vascular pythiosis in a thalassemic patient","volume":"17","author":"Laohapensang","year":"2009","journal-title":"Vascular"},{"key":"B15-20240828","first-page":"16","article-title":"The pathology of bursattee","volume":"19","author":"Smith","year":"1884","journal-title":"Vet J"},{"key":"B16-20240828","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1093\/jac\/dkv008","article-title":"Treatment outcomes of surgery, antifungal therapy and immunotherapy in ocular and vascular human pythiosis:A retrospective study of 18 patients","volume":"70","author":"Permpalung","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"B17-20240828","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1177\/104063870201400403","article-title":"Evaluation of microbial culture techniques for the isolation of Pythium insidiosum from equine tissues","volume":"14","author":"Grooters","year":"2002","journal-title":"J Vet Diagn Invest"},{"key":"B18-20240828","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1097\/ICO.0000000000001504","article-title":"Pythium keratitis leading to fatal cavernous sinus thrombophlebitis","volume":"37","author":"Rathi","year":"2018","journal-title":"Cornea"},{"key":"B19-20240828","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1097\/ICO.0000000000001244","article-title":"Pythium insidiosum keratitis:Histopathology and rapid novel diagnostic staining technique","volume":"36","author":"Mittal","year":"2017","journal-title":"Cornea"},{"key":"B20-20240828","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1080\/02713683.2019.1676911","article-title":"Clinical and histopathological evaluation of a rabbit model for pythium insidiosum keratitis","volume":"45","author":"Kalra","year":"2020","journal-title":"Curr Eye Res"},{"key":"B21-20240828","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.vetmic.2010.07.019","article-title":"Pythium insidiosum:An overview","volume":"146","author":"Gaastra","year":"2010","journal-title":"Vet Microbiol"},{"issue":"20","key":"B22-20240828","first-page":"30512","article-title":"Successful strategic management of Pythium insidiosum keratitis with antibiotics","volume":"S0161-6420","author":"Bagga","year":"2020","journal-title":"Ophthalmology"},{"key":"B23-20240828","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1128\/JCM.06126-11","article-title":"Molecular diagnosis of subcutaneous Pythium insidiosum infection by use of PCR screening and DNA sequencing","volume":"50","author":"Salipante","year":"2012","journal-title":"J Clin Microbiol"},{"key":"B24-20240828","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/S0002-9394(03)00908-5","article-title":"Ocular pythiosis:Is it under-diagnosed?","volume":"137","author":"Krajaejun","year":"2004","journal-title":"Am J Ophthalmol"},{"key":"B25-20240828","first-page":"167","article-title":"Evaluation of nested PCR technique for detection of Pythium insidiosum in pathological specimens from patients with suspected fungal keratitis","volume":"45","author":"Kosrirukvongs","year":"2014","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"B26-20240828","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s11046-013-9695-3","article-title":"Evaluation for the clinical diagnosis of Pythium insidiosum using a single-tube nested PCR","volume":"176","author":"Thongsri","year":"2013","journal-title":"Mycopathologia"},{"key":"B27-20240828","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1099\/jmm.0.000117","article-title":"Detection of the oomycete Pythium insidiosum by real-time PCR targeting the gene coding for exo-1,3-b-glucanase","volume":"64","author":"Keeratijarut","year":"2015","journal-title":"J Med Microbiol"},{"key":"B28-20240828","doi-asserted-by":"crossref","first-page":"3970","DOI":"10.1128\/JCM.42.9.3970-3974.2004","article-title":"Identification of emerging human-pathogenic Pythium insidiosum by serological and molecular assay-based methods","volume":"42","author":"Vanittanakom","year":"2004","journal-title":"J Clin Microbiol"},{"key":"B29-20240828","article-title":"Successful management of pediatric pythium insidiosum keratitis with cyanoacrylate glue, linezolid, and azithromycin:Rare case report","author":"Gurnani","year":"2021","journal-title":"Eur J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1808_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:12:42Z","timestamp":1787843562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_1808_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,30]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1808_20","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,30]]},"assertion":[{"value":"2020-06-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}