Posters

Penicillium keratitis in inactive vernal conjunctivitis

Poster Details

First Author: Ü. Çallı TURKEY

Co Author(s): T. Ayyildiz   S. Kocabas   B. Kandemir              

Abstract Details

Purpose:

The purpose of this report is to describe penicillium keratitis in a patient with inactive vernal conjunctivitis.A 23-year-old male patient referred to our clinic due to keratitis unresponsive to treatment. The patient was already treated with topical fortified cefazol, genta and cyclopentolate 1%. The cornea in the right eye had a unknown primary, mild corneal haze (figure 1). The left eye had a 2x2mm infiltrate and epithelial defect was seen in the inferiornasal parasantral cornea and it involved less than half the stromal thickness. The surrounding cornea was non-oedematous. Endothelial plaque, hypopyon or satellite lesions were not note (figure 2).

Setting:

Ümraniye Research and Training Hospital Clinic of Ophtalmolgy, Istanbul, Turkey.

Methods:

We stopped the treatment for 24 hours. The patient was initially treated with topical fortified vancomycin (50 mg/ml), amikacin (33 mg/ml) and cyclopentolate 1% after cultures specimens were acquired. We continued to treatment until the results of culture. The condition was stabil but the response to treatment was insufficient.The culture resulted as Penicillium. We have encountered penicillium keratitis first time and we searched the literature.

Results:

We noticed a penicillium keratitis in vernal keratoconjunktivitis as a case report. We diagnosed the patient with the same diagnose as penicillium keratitis in vernal conjunktivitis.The scar in the right eye was diagnosed shield ulcer scar.The patient confirmed vernal keratoconjunktivitis in the childhood.The patient was started on topical amphotericin B 0.15% (every hour for first day than five times a day) and cyclopentolate 1% (three times a day) in the left eye. The epithelial defect closed in two days and the corneal infiltrate resolved completely in two weeks with a small scar formation (figure 3).

Conclusions:

Vernal Keratoconjunctivitis (VKC) is an ocular allergic manifestation, usually affects young males and is commonly seen in warm climates, characterised by bilateral inflammation of the conjunctiva and papillary hypertrophy in the tarsal and the limbal region. Bacterial superinfection has been reported rarely in vernal shield ulcers. Fungal corneal ulcers occur in 0.8% of patients with vernal keratoconjunctivitis. Chronic topical corticosteroid use and corneal trauma have been identified as risk factors for mycotic keratitis in such patients. We report an unusual case of fungal keratitis by Penicillium, with history of shield ulcer two year ago in the other eye.

Financial Disclosure:

None