First Author: G.Cavallini ITALY
Co Author(s): P. Ducange V. Volante C. Benatti M. Forlini
Purpose:
This is a case of fungal corneal infection due to Fusarium in a previously healthy female 39-years-old patient following Photo Refractive Keratectomy (PRK). The BCVA of the affected eye was limited to hand movements. We report the diagnostic work-up, the clinical history, the medical and surgical treatment, and the final outcome.
Setting:
Institute of Ophthalmology, University of Modena, Italy
Methods:
We treated a Fusarium Keratitis following Photo Refractive Keratectomy (PRK) with topical and systemic administration of amphotericin B and voriconazole, in conjunction with penetrating keratoplasty. Cornea transplantation was repeated 3 weeks after the first PK because of fungal infection relapse. We present the biomicroscopy photographs of the anterior segment of the affected eye.
Results:
Topical and systemic use of antimycotic drugs, in conjunction with the second penetrating keratoplasty, led to complete eradication of the Fusarium infection, and good visual outcome (final BCVA 0.7). Microbiological tests suggested Fusarium solani or Fusarium oxisporium. These species show a high degree of homology in some aspects of morphology and the macroscopic and microscopic morphological features often change in subculture.
To confirm definitively the identification, a matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) analysis was executed to have a proven and rapid diagnosis of Fusarium solani. Contemporaneously techniques of amplified DNA had been performed.
Conclusions:
The association of amphotericin B and voriconazole showed efficacy in this clinical case for the treatment of Fusarium solani keratitis.
Contemporary mycological tests and molecular analysis could have potential advantages for rapid detection of Fusarium solani.
This might have significance for early diagnosis and better treatment of fungal keratitis. FINANCIAL DISCLOSURE?: No
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