A Case of Fungal Keratitis Caused by Paecilomyces lilacinus after Penetrating Keratoplasty.
10.3341/jkos.2014.55.9.1384
- Author:
Jae Yon WON
1
;
Ji Young SHIN
;
Je Hyung HWANG
;
Choun Ki JOO
Author Information
1. Catholic Institute for Visual Science, Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. ckjoo@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Corneal ulcer;
Paecilomyces lilacinus;
Penetrating keratoplasty
- MeSH:
Aged;
Amphotericin B;
Ceftazidime;
Coloring Agents;
Corneal Transplantation;
Corneal Ulcer;
Humans;
Intravitreal Injections;
Keratitis*;
Keratoplasty, Penetrating*;
Male;
Ophthalmic Solutions;
Paecilomyces*;
Transplants
- From:Journal of the Korean Ophthalmological Society
2014;55(9):1384-1387
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of corneal ulcer caused by Paecilomyces lilacinus after penetrating keratoplasty. CASE SUMMARY: A 67-year-old male with a history of penetrating keratoplasty in the left eye 7 years prior and re-penetrating keratoplasty in the left eye due to graft failure in June 2013, visited our clinic for ocular pain and conjunctival injection in the left eye 3 days in duration. Corneal scrapings were performed for Gram and fungal stains and cultures. The patient was admitted to the hospital for hourly topical fortified ceftazidime and amphotericin B. Despite intensive topical therapy, no improvement was observed. Three days later, fungal culture confirmed Paecilomyces lilacinus and topical voriconazole was prepared from the intravenous formulation and was administered topically and intravenously. Despite medical therapy with voriconazole, perforation occurred requiring a tectonic keratoplasty. CONCLUSIONS: Keratitis caused by Paecilomyces lilacinus is difficult to eradicate and refractory to amphotericin B. We suggest early use of topical eyedrops, intracameral, and intravitreal injections of voriconazole may be an appropriate treatment for patients with Paecilomyces lilacinus keratitis.
