AIM: To report a rare case of severe contact lens related fungal keratitis due to fusarium sp, which not only was successfully treated with therapeutic penetrating keratoplasty but also aided in the confirmation of diagnosis. METHODS:Case report.RESULTS: A 39-year-old private clerk Malay lady who wore extended wear soft contact lens for the past 18 years, presented with acute right eye pain and redness for 10 days duration. Ocular examination showed multiple round feathery paracentral corneal ulcers with presence of minimal hypopyon. Clinical diagnosis of presumed fungal keratitis was made. She was treated with broad spectrum topical antibiotics and antifungal agents after repeated corneal scrapping was negative either for fungi or for the bacteria. However, she developed deterioration of the right eye keratitis. Other topical and systemic antifungal agents were instituted. Unfortunately the right corneal ulcer became further deteriorating. Finally a therapeutic penetrating keratoplasty has done in order to preserve the globe and limit the infection after one and a half months of presentation. The diagnosis and the etiology agent were only confirmed based on histopathological examina-tion and polymerase chain reaction (PCR) from corneal button revealed fusarium sp.CONCLUSION:This case highlights the rare case of fusarium sp as an etiology of severe contact lens related fungal keratitis. This case also illustrates the challenge in managing fungal keratitis. Therapeutic penetrating keratoplasty is the ultimate choice in controlling further infection and perserving the globe.

ABSTRACT The oral microbiome comprises several hundreds of bacterial species that contribute to periodontitis, the most complex polymicrobial inflammatory disorder. Porphyromonas gingivalis is a prominent periodontitis pathogen that produces gingipains as a major virulent factor. Gingipain facilitates P. gingivalis survival, pathogenicity, and growth. Several genes were identified to have a role in the regulating of P. gingivalis pathogenesis. Studies suggest that gingipains inhibition is key for the successful treatment of periodontitis. As of now, several gingipain inhibitors have been developed, some exhibit high inhibition activity against gingipains. However, most inhibitors offer unknown toxicity and undesirable side effects. Hence, the development of highly potent and safe gingipain inhibitor is a major concern for periodontitis treatment. The present review highlights the connectivity between P. gingivalis, virulent factors, and its gene, periodontitis, and gingipain inhibitors. Development of gingipains inhibitors would not only treat periodontitis but would also assist in the treatment of other associated systemic diseases, for example: rheumatoid arthritis, cardiovascular diseases, diabetes, and Alzheimer's disease.
Porphyromonas gingivalis--pathogenicity ; Gingipain Cysteine Endopeptidases