TY  - JOUR
A1  - Egenolf, Nadine
A1  - Altenschildesche, Caren Meyer zu
A1  - Kreß, Luisa
A1  - Eggermann, Katja
A1  - Namer, Barbara
A1  - Gross, Franziska
A1  - Klitsch, Alexander
A1  - Malzacher, Tobias
A1  - Kampik, Daniel
A1  - Malik, Rayaz A.
A1  - Kurth, Ingo
A1  - Sommer, Claudia
A1  - Üçeyler, Nurcan
T1  - Diagnosing small fiber neuropathy in clinical practice: a deep phenotyping study
JF  - Therapeutic Advances in Neurological Disorders
N2  - Background and aims:
Small fiber neuropathy (SFN) is increasingly suspected in patients with pain of uncertain origin, and making the diagnosis remains a challenge lacking a diagnostic gold standard.
	
Methods:
In this case–control study, we prospectively recruited 86 patients with a medical history and clinical phenotype suggestive of SFN. Patients underwent neurological examination, quantitative sensory testing (QST), and distal and proximal skin punch biopsy, and were tested for pain-associated gene loci. Fifty-five of these patients additionally underwent pain-related evoked potentials (PREP), corneal confocal microscopy (CCM), and a quantitative sudomotor axon reflex test (QSART).
	
	
Results:
Abnormal distal intraepidermal nerve fiber density (IENFD) (60/86, 70%) and neurological examination (53/86, 62%) most frequently reflected small fiber disease. Adding CCM and/or PREP further increased the number of patients with small fiber impairment to 47/55 (85%). Genetic testing revealed potentially pathogenic gene variants in 14/86 (16%) index patients. QST, QSART, and proximal IENFD were of lower impact.
	
Conclusion:
We propose to diagnose SFN primarily based on the results of neurological examination and distal IENFD, with more detailed phenotyping in specialized centers.
KW  - algorithm
KW  - diagnosis
KW  - neurological examination
KW  - skin punch biopsy
KW  - small fiber neuropathy
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232019
SN  - 1756-2864
VL  - 14
ER  - 
TY  - JOUR
A1  - Walther, Grit
A1  - Zimmermann, Anna
A1  - Theuersbacher, Johanna
A1  - Kaerger, Kerstin
A1  - Lilienfeld-Toal, Marie von
A1  - Roth, Mathias
A1  - Kampik, Daniel
A1  - Geerling, Gerd
A1  - Kurzai, Oliver
T1  - Eye infections caused by filamentous fungi: spectrum and antifungal susceptibility of the prevailing agents in Germany
JF  - Journal of Fungi
N2  - Fungal eye infections can lead to loss of vision and blindness. The disease is most prevalent in the tropics, although case numbers in moderate climates are increasing as well. This study aimed to determine the dominating filamentous fungi causing eye infections in Germany and their antifungal susceptibility profiles in order to improve treatment, including cases with unidentified pathogenic fungi. As such, we studied all filamentous fungi isolated from the eye or associated materials that were sent to the NRZMyk between 2014 and 2020. All strains were molecularly identified and antifungal susceptibility testing according to the EUCAST protocol was performed for common species. In total, 242 strains of 66 species were received. Fusarium was the dominating genus, followed by Aspergillus, Purpureocillium, Alternaria, and Scedosporium. The most prevalent species in eye samples were Fusarium petroliphilum, F. keratoplasticum, and F. solani of the Fusarium solani species complex. The spectrum of species comprises less susceptible taxa for amphotericin B, natamycin, and azoles, including voriconazole. Natamycin is effective for most species but not for Aspergillus flavus or Purpureocillium spp. Some strains of F. solani show MICs higher than 16 mg/L. Our data underline the importance of species identification for correct treatment.
KW  - eye infection
KW  - fungal infection
KW  - keratitis
KW  - antifungal susceptibility
KW  - natamycin
KW  - Fusarium
KW  - Purpureocillium
KW  - Aspergillus
KW  - Alternaria
KW  - Scedosporium
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-241810
SN  - 2309-608X
VL  - 7
IS  - 7
ER  -