• 1 Marlar AJ, Miller PE & Canton DD, et al. Canine keratomycosis: a report of eight cases and literature review. J Am Anim Hosp Assoc 1994; 30: 331340.

    • Search Google Scholar
    • Export Citation
  • 2 Binder DR, Sugrue JE, Herring IP. Acremonium keratomycosis in a cat. Vet Ophthalmol 2011; 14 (suppl 1):111116.

  • 3 Dalton JR, Ainsworth H. Mycotic keratoconjunctivitis in 12-day-old red-legged partridges (Alectoris rufa). Vet Rec 2011; 168: 590.

  • 4 Elligott CR, Wilkie DA & Kuonen VJ, et al. Primary Aspergillus and Fusarium keratitis in a Holstein cow. Vet Ophthalmol 2006; 9: 175178.

    • Search Google Scholar
    • Export Citation
  • 5 Myers DA, Isaza R & Ben-Shlomo G, et al. Fungal keratitis in a gopher tortoise (Gopherus polyphemus). J Zoo Wildl Med 2009; 40: 579582.

  • 6 Collete BE, Curry OH. Mycotic keratitis in a reticulated python. J Am Vet Med Assoc 1978; 173: 11171118.

  • 7 Hoppes S, Gurfield N & Flammer K, et al. Mycotic keratitis in a blue-fronted Amazon parrot (Amazona aestiva). J Avian Med Surg 2000; 14: 185189.

    • Search Google Scholar
    • Export Citation
  • 8 Gaarder JE, Rebhun WC & Ball MA, et al. Clinical appearances, healing patterns, risk factors, and outcomes of horses with fungal keratitis: 53 cases (1978–1996). J Am Vet Med Assoc 1998; 213: 105112.

    • Search Google Scholar
    • Export Citation
  • 9 Andrew SE, Brooks DE & Smith PJ, et al. Equine ulcerative keratomycosis: visual outcome and ocular survival in 39 cases (1987–1996). Equine Vet J 1998; 30: 109116.

    • Search Google Scholar
    • Export Citation
  • 10 Grahn B, Wolfer J & Keller C, et al. Equine keratomycosis: clinical and laboratory findings in 23 cases. Prog Vet Comp Ophthalmol 1993; 3: 27.

    • Search Google Scholar
    • Export Citation
  • 11 Galera PD, Brooks DE. Optimal managment of equine keratomycosis. Vet Med Res Rep 2012; 3: 717.

  • 12 Galán A, Martin-Suarez EM & Gallardo JM, et al. Clinical findings and progression of 10 cases of equine ulcerative keratomycosis. Equine Vet Educ 2009; 21: 236242.

    • Search Google Scholar
    • Export Citation
  • 13 Brooks DE, Andrew SE & Denis H, et al. Rose bengal positive epithelial microerosions as a manifestation of equine keratomycosis. Vet Ophthalmol 2000; 3: 8386.

    • Search Google Scholar
    • Export Citation
  • 14 Hamilton HI, McLaughlin SA & Whitley EM, et al. Histological findings in corneal stromal abscesses of 11 horses: correlation with cultures and cytology. Equine Vet J 1994; 26: 448453.

    • Search Google Scholar
    • Export Citation
  • 15 Brooks DE, Plummer CE & Mangan BG, et al. Equine subepithelial keratomycosis. Vet Ophthalmol 2013; 16: 9396.

  • 16 Borkowski R, Moore PA & Mumford S, et al. Adaptations of subpalpebral lavage systems used for llamas (Lama glama) and a harbor seal (Phoca vitulina). J Zoo Wildl Med 2007; 38: 453459.

    • Search Google Scholar
    • Export Citation
  • 17 Fischer K, Hendrix D. Conjunctivitis and ulcerative keratitis secondary to conjunctival plant foreign bodies in a herd of alpacas (Lama pacos). Vet Ophthalmol 2012; 15: 110114.

    • Search Google Scholar
    • Export Citation
  • 18 Pirie CG, Pizzirani S, Parry NM. Corneal epithelial inclusion cyst in a llama. Vet Ophthalmol 2008; 11: 111113.

  • 19 Richter M, Grest P, Spiess B. Bilateral lipid keratopathy and atherosclerosis in an alpaca (Lama pacos) due to hypercholesterolemia. J Vet Intern Med 2006; 20: 15031507.

    • Search Google Scholar
    • Export Citation
  • 20 Rodriguez-Alvaro A, Gonzalez-Alonso-Alegre EM & Delclaux-Real del Asua M, et al. Surgical correction of a corneal perforation in an alpaca (Lama pacos). J Zoo Wildl Med 2005; 36: 336339.

    • Search Google Scholar
    • Export Citation
  • 21 Gelatt KN, Otzen Martinic GB & Flaneig JL, et al. Results of ophthalmic examinations of 29 alpacas. J Am Vet Med Assoc 1995; 206: 12041207.

    • Search Google Scholar
    • Export Citation
  • 22 Gionfriddo JR, Gionfriddo JP, Krohne SG. Ocular diseases of llamas: 194 cases (1980–1993). J Am Vet Med Assoc 1997; 210: 17841787.

  • 23 Gionfriddo JR, Gabal MA, Betts DM. Fungal flora of the healthy camelid conjunctival sac. Am J Vet Res 1992; 53: 643645.

  • 24 Gionfriddo JR. Ophthalmology of South American camelids. Vet Clin North Am Food Anim Pract 2010; 26: 531555.

  • 25 Ledbetter EC, Patten VH & Scarlett JM, et al. In vitro susceptibility patterns of fungi associated with keratomycosis in horses of the northeastern United States: 68 cases (1987–2006). J Am Vet Med Assoc 2007; 231: 10861091.

    • Search Google Scholar
    • Export Citation
  • 26 Ledbetter EC, Scarlett JM. In vivo confocal microscopy of the normal equine cornea and limbus. Vet Ophthalmol 2009; 12 (suppl 1):5764.

    • Search Google Scholar
    • Export Citation
  • 27 Ledbetter EC, Irby NL, Kim SG. In vivo confocal microscopy of equine fungal keratitis. Vet Ophthalmol 2011; 14: 19.

  • 28 Barton MH. Equine keratomycosis. Compend Contin Educ Pract Vet 1992; 14: 936944.

  • 29 Sansom J, Featherstone H, Barnett KC. Keratomycosis in six horses in the United Kingdom. Vet Rec 2005; 156: 1317.

  • 30 Peiffer RL. Keratomycosis in the horse. Equine Pract 1975; 1: 3237.

  • 31 Wada S, Hobo S & Ode H, et al. Equine keratomycosis in Japan. Vet Ophthalmol 2013; 16: 19.

  • 32 Hodgson DR, Jacobs KA. Two cases of Fusarium keratomycosis in the horse. Vet Rec 1982; 110: 520522.

  • 33 Coad CT, Robinson NM, Wilhelmus KR. Antifungal sensitivity testing for equine keratomycosis. Am J Vet Res 1985; 46: 676678.

  • 34 Moore CP, Collins BK, Fales WH. Antibacterial susceptibility patterns for microbial isolates associated with infectious keratitis in horses: 63 cases (1986–1994). J Am Vet Med Assoc 1995; 207: 928933.

    • Search Google Scholar
    • Export Citation
  • 35 Reed Z, Thomasy SM & Good KL, et al. Equine keratomycoses in California from 1987 to 2010 (47 cases). Equine Vet J 2013; 45: 361366.

  • 36 Beech J, Sweeney CR, Irby N. Keratomycosis in 11 horses. Equine Vet J Suppl 1983;(2):3944.

  • 37 Tu EY. Alternaria keratitis: clinical presentation and resolution with topical fluconazole or intrastromal voriconazole and topical caspofungin. Cornea 2009; 28: 116119.

    • Search Google Scholar
    • Export Citation
  • 38 Shin JY, Kim HM, Hong JW. Keratitis caused by Verticillium species. Cornea 2002; 21: 240242.

  • 39 Figueira L, Pinheiro D & Moreira R, et al. Beauveria bassiana keratitis in bullous keratopathy: antifungal sensitivity testing and management. Eur J Ophthalmol 2012; 22: 814818.

    • Search Google Scholar
    • Export Citation
  • 40 Fazakas S. Report on oculomycoses due to the fungus flora of human eyes. Ophthalmologica 1951; 121: 249258.

  • 41 Brooks DE, Andrew SE & Dillavou CL, et al. Antimicrobial susceptibility patterns of fungi isolated from horses with ulcerative keratomycosis. Am J Vet Res 1998; 59: 138142.

    • Search Google Scholar
    • Export Citation
  • 42 Moore CP, Heller N & Majors LJ, et al. Prevalence of ocular microorganisms in hospitalized and stabled horses. Am J Vet Res 1988; 49: 773777.

    • Search Google Scholar
    • Export Citation
  • 43 Pearce JW, Giuliano EA, Moore CP. In vitro susceptibility patterns of Aspergillus and Fusarium species isolated from equine ulcerative keratomycosis cases in the midwestern and southern United States with inclusion of the new antifungal agent voriconazole. Vet Ophthalmol 2009; 12: 318324.

    • Search Google Scholar
    • Export Citation
  • 44 Takezawa Y, Shiraishi A & Noda E, et al. Effectiveness of in vivo confocal microscopy in detecting filamentous fungi during clinical course of fungal keratitis. Cornea 2010; 29: 13461352.

    • Search Google Scholar
    • Export Citation
  • 45 Brasnu E, Bourcier T & Dupas B, et al. In vivo confocal microscopy in fungal keratitis. Br J Ophthalmol 2007; 91: 588591.

  • 46 Samuelson DA, Andresen TL, Gwin RM. Conjunctival fungal flora in horses, cattle, dogs, and cats. J Am Vet Med Assoc 1984; 184: 12401242.

    • Search Google Scholar
    • Export Citation
  • 47 Gemensky-Metzler AJ, Wilkie DA & Kowalski JJ, et al. Changes in bacterial and fungal ocular flora of clinically normal horses following experimental application of topical antimicrobial or antimicrobial-corticosteroid ophthalmic preparations. Am J Vet Res 2005; 66: 800811.

    • Search Google Scholar
    • Export Citation
  • 48 Johns IC, Baxter K & Booler H, et al. Conjunctival bacterial and fungal flora in healthy horses in the UK. Vet Ophthalmol 2011; 14: 195199.

    • Search Google Scholar
    • Export Citation

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Characterization of fungal keratitis in alpacas: 11 cases (2003–2012)

Eric C. Ledbetter DVM, DACVO1, Keith W. Montgomery DVM, DACVO2, Matthew P. Landry DVM, DACVO3, and Nathan C. Kice DVM, DACVO4
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  • 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853
  • | 4 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853

Abstract

Objective—To describe clinical, microbiological, in vivo confocal microscopic, and histopathologic features of fungal keratitis in alpacas and to estimate prevalence of the disease in a population of alpacas from the northeastern United States.

Design—Retrospective case series.

Animals—11 alpacas.

Procedures—Medical records of alpacas evaluated by the ophthalmology service of a veterinary teaching hospital were searched to identify animals with a clinical diagnosis of fungal keratitis and positive results for fungal culture of a corneal sample between 2003 and 2012. Signalment and historical, clinical, and microbiological details were recorded. Results of cytologic, histopathologic, and in vivo confocal microscopic corneal examinations were collected when available.

Results—Fungal keratitis was diagnosed in 11 of 169 (6.5%) alpacas that underwent ophthalmologic examination by the ophthalmology service during the study period. Ten of the 11 alpacas were evaluated in the summer or fall months. Corneal lesions included stromal ulcer, stromal abscess, corneal perforation, and nonulcerative keratitis. Aspergillus fumigatus and Fusarium solani were the most frequently cultured fungi. Fungi were also identified through corneal cytologic examination, histologic examination, or in vivo confocal microscopy in 9 alpacas. Historically, 2 alpacas were evaluated following external ocular trauma and 1 following corneal foreign body removal. Nine alpacas had received topical treatment with antimicrobials and 2 had antimicrobial-corticosteroid combinations administered topically prior to referral. Nine of 10 alpacas for which follow-up information was available were successfully treated, with globe and vision retention.

Conclusions and Clinical Relevance—Fungal keratitis was a relatively common ocular disease in this population of alpacas and appeared to share several clinical features with keratomycosis in horses.

Contributor Notes

Dr. Montgomery's present address is College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607.

Dr. Landry's present address is Animal Eye Clinic, 5339 Roosevelt Way NE, Seattle, WA 98105.

Dr. Kice's present address is Midwest Veterinary Referral Center, 17497 N Outer 40, Chesterfield, MO 63005.

Address correspondence to Dr. Ledbetter (ecl32@cornell.edu).