Posters

Keratomycosis complicated by endophthalmitis due to an unusual fungus: scytalidium hyalinum

Poster Details

First Author: T.Abdellaoui MOROCCO

Co Author(s): Y. Malek   K. Reda   A. Oubaaz              

Abstract Details

Purpose:

Describe the case of keratomycosis complicated by endophthalmitis due to an unusual fungus: scytalidium hyalinum

Setting:

Military teaching Hospital Mohamed V, Rabat, Morocco

Methods:

62-year-old diabetic patient, admitted to the emergency room for ocular pain and redness with a decreased visual acuity (VA) in his left eye. The symptoms appeared spontaneously and progressively worsening for several days, with no record of ocular trauma, nor use of contact lenses. Visual acuity was limited to hand motion. The slit lamp examination showed a deep greyish central corneal abscess measuring 8 mm in diameter with a perilesional edema and an important inflammatory reaction in the anterior chamber. Ocular ultrasound found mobile intravitreal echoes with no retinal detachment. The contralateral eye examination was normal

Results:

The patient initially benefited from empiric treatment: Vancomycin and Ceftazidime by intravitreal injection and fortified eyedrops. The mycological study found a scytalidium hyalinum, and the treatment was then adapted by Voriconazole, by both an intravitreal injection, and oral: 800 mg on the 1st day then 400mg per day, for 6 weeks. The evolution was positive marked by the improvement of the VA which passed to 1/20 and progressive and complete cicatrization of the abscess within 6 weeks with the development of an important vascularization of the scar.

Conclusions:

Scytalidium includes keratinophilic fungi that are clinically indistinguishable from dermatophytes. The Contamination usually occurs by contact of the bare foot with soiled grounds or plants.  The ocular involvement is exceptional, as there’s only a record of 2 cases of Scytalidium keratomycosis in the literature.

Financial Disclosure:

None