Fungal keratitis caused by Paecilomyces lilacinus associated with a retained intracorneal hair

被引:37
作者
Anderson, KL
Mitra, S
Salouti, R
Pham, TA
Taylor, HR
机构
[1] Univ Melbourne, Royal Victorian Eye & Ear Hosp, Dept Ophthalmol, Melbourne, Vic, Australia
[2] Univ Melbourne, Royal Victorian Eye & Ear Hosp, Ctr Eye Res Australia, Melbourne, Vic, Australia
[3] St Vincents Hosp, Dept Microbiol, Fitzroy, Vic 3065, Australia
关键词
corneal ulcer; fungal keratitis; Paecilomyces lilacinus; corneal biopsy; voriconazole;
D O I
10.1097/01.ico.0000114126.63670.4f
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Objective: To report a case of fungal keratitis caused by Paeciloin myces lilacinus (P. filacinus) associated with a retained intracorneal hair. Methods: A 61-year-old man developed pain, decreased vision, hyperemia, and corneal infiltrates in his right eye without any predisposing factor. An intracorneal hair had migrated superiorly in the corneal stroma, giving rise to 3 separate stromal infiltrates. The patient demonstrated a waxing and waning course over several months despite antimicrobial and steroid therapy. Results: Histopathologic examination of a corneal biopsy specimen disclosed the presence of fungal elements, and intensive antifungal therapy was initiated. Verticillium sp. was initially identified as the causative organism, but after failure to improve on topical natamycin, subsequent investigations demonstrated the pathogen to be P. filacinus that was resistant to routine antifungal agents. The patient was then initiated on systemic voriconazole and terbinafine. He responded well to treatment and ultimately recovered a best-corrected visual acuity of 6/15 in the affected eye. Conclusion: This is the first case of P. lilacinus keratitis associated with a retained intracorneal hair. Hair in the cornea could be a predisposing factor for this infection. Early corneal biopsy should be considered to properly diagnose and manage atypical keratitis and to prevent further complications.
引用
收藏
页码:516 / 521
页数:6
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