Mykotische Keratitis – Zeichen, Diagnostik, Therapie

Zusammenfassung

Die mykotische Keratitis ist eine seltene, aber ernsthafte Infektion der Hornhaut, die insbesondere bei Kontaktlinsenträgern und Patienten mit systemischen Erkrankungen wie Diabetes oder Immunsuppression auftritt. Sie wird häufig durch filamentöse Pilze wie Fusarium spp. und Aspergillus spp. oder durch Hefen, hier insbesondere Candida spp. verursacht. Die Diagnostik der mykotischen Keratitis ist anspruchsvoll, da klinische Zeichen oft unspezifisch sind. Die Diagnostik umfasst die In-vivo-Konfokalmikroskopie, Pilzkulturen und histopathologische Untersuchungen. Eine frühzeitige und gezielte Diagnosestellung ist entscheidend, um schwerwiegende Komplikationen zu vermeiden. Die Therapie basiert auf der Anwendung von Antimykotika wie Natamycin und Voriconazol. In therapierefraktären Fällen ist eine frühzeitige chirurgische Intervention, meist auch mittels Keratoplastik erforderlich. Ziel dieses Beitrags ist es, einen umfassenden Überblick über die Ätiologie, Diagnostik und Therapie der mykotischen Keratitis zu geben und klinische Empfehlungen für ein effektives Management dieser herausfordernden Erkrankung bereitzustellen.

Schlüsselwörter

Keratomykose - infektiöse Keratitis - kontaktlinsenassoziierte Keratitis - Candida spp. - Fusarium spp.

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