Introduction: Pythium insidiosum keratitis (PIK) is a rapidly progressing ocular disease predominantly found in tropical and subtropical regions. Characterized by severe corneal damage and high morbidity, this infection poses significant challenges in diagnosis and management, necessitating effective anti-infective therapies.
Areas covered: This report delves into the pathophysiology, clinical and microbiological diagnosis, and detailed insights into the anti-infective therapy for PIK, outlining current diagnostic challenges that complicate treatment. We review existing anti-infective therapies, including their efficacy and limitations, and discuss the role of surgical interventions in managing advanced cases. The report also highlights ongoing research into novel treatment approaches and the critical need for developing targeted therapies.
Expert opinion: Despite advances in understanding PIK, treatment remains complex due to pathogen resistance and diagnostic hurdles. Future research should focus on innovative anti-infective strategies, improved diagnostic techniques, and global surveillance to enhance therapeutic outcomes. Collaboration between ophthalmologists, microbiologists, and pharmacologists is essential to advance treatment protocols and improve patient prognosis.
Keywords: Pythium insidiosum keratitis; azithromycin; linezolid; natamycin; voriconazole.