{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:19:10Z","timestamp":1787750350664,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:p>\n                    Human pythiosis keratitis is a rare but potentially sight-threatening infection. We report the case of an 8-year-old boy who developed a nonhealing corneal ulcer after finger nail trauma that did not respond to broad-spectrum antibiotics. Initial cultures identified\n                    <jats:italic toggle=\"yes\">Staphylococcus warneri<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Streptococcus mitis<\/jats:italic>\n                    . Worsening clinical signs prompted repeat investigations, which confirmed\n                    <jats:italic toggle=\"yes\">Pythium insidiosum<\/jats:italic>\n                    through polymerase chain reaction. Despite intensive topical (natamycin and voriconazole) and systemic antifungals (voriconazole), the ulcer progressed with biofilm formation. Manual debridement and a revised regimen of topical linezolid 0.2% alternating with topical ceftazidime 5% led to significant clinical improvement. After 8 weeks of topical therapy and regular debridement, the infection eventually resolved with a paracentral scar and unaided visual acuity of 6\/6. This case highlights the diagnostic complexity of\n                    <jats:italic toggle=\"yes\">Pythium<\/jats:italic>\n                    keratitis and the crucial role of early microbial identification in pediatric ocular trauma. We attribute the successful management in this case to prompt diagnostic reevaluation, targeted antimicrobial therapy, and repeated scraping of ulcer biofilm.\n                  <\/jats:p>","DOI":"10.4103\/ojo.ojo_377_25","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T02:00:10Z","timestamp":1782266410000},"page":"248-251","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Successful management of pediatric Pythium insidiosum keratitis \u2013 A case report highlighting the role of targeted antimicrobial therapy and mechanical debridement"],"prefix":"10.4103","volume":"19","author":[{"given":"Moein","family":"Zeinalddin","sequence":"first","affiliation":[{"name":"Ophthalmology Residency Program, Oman Medical Specialty Board (OMSB), Muscat, Oman; Department of Ophthalmology, University Medical City (UMC), Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Al Maskari","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Cornea, Cataract and Refractive Surgery, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Kenawy","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Cornea, Cataract and Refractive Surgery, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turkiya","family":"Al-Siyabi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University Medical City (UMC) , Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagi","family":"Elsidig","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, University Medical City (UMC) , Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Al Balushi","sequence":"additional","affiliation":[{"name":"Department of Bacteriology Section, Parasitology, Mycology and Malaria Department, Central Public Health Laboratory, Center for Disease Control and Prevention, Ministry of Health, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pediatric Ophthalmology Unit, University Medical City (UMC), Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"R1-20260624","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 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treatment of Pythium insidiosum keratitis","volume":"102","author":"Bagga","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"R6-20260624","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.2147\/OPTH.S303721","article-title":"Clinical characteristics, histopathology, and treatment outcomes of Pythium keratitis: A retrospective cohort study","volume":"15","author":"Puangsricharern","year":"2021","journal-title":"Clin Ophthalmol"},{"key":"R7-20260624","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.carbpol.2016.10.053","article-title":"Extraction, characterization and biological activity of a (1,3)(1,6)-?-d-glucan from the pathogenic oomycete Pythium insidiosum","volume":"157","author":"Tondolo","year":"2017","journal-title":"Carbohydr Polym"},{"key":"R9-20260624","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":"R10-20260624","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":"R11-20260624","doi-asserted-by":"crossref","first-page":"1430032","DOI":"10.3389\/fcimb.2024.1430032","article-title":"Pythium insidiosum:an emerging pathogen that is easily misdiagnosed and given treatment as a fungus","volume":"14","author":"Hu","year":"2024","journal-title":"Front Cell Infect Microbiol"},{"key":"R12-20260624","first-page":"801","article-title":"Human pythiosis: Emergence of fungal-like organism","volume":"185","author":"Permpalung","year":"2020","journal-title":"Mycopathologia"},{"key":"R13-20260624","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1186\/s13256-021-03189-3","article-title":"Pythium insidiosum keratitis reported in China, raising the alertness to this fungus-like infection:a case series","volume":"15","author":"Hou","year":"2021","journal-title":"J Med Case Rep"}],"container-title":["Oman Journal of 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