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Successful treatment of resistant ocular fusariosis with posaconazole (SCH-56592)

Elmer Y Tu1, David L McCartney, Richard F Beatty

  • 1Department of Ophthalmology, University of Illinois at Chicago, Chicago, Illinois, USA. etu@uic.edu

American Journal of Ophthalmology
|January 30, 2007
PubMed
Abstract

Insights

Systemic posaconazole successfully treated three cases of pan-resistant Fusarium keratitis and endophthalmitis that did not respond to other antifungal treatments. This offers a new therapeutic option for severe fungal eye infections.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Fusarium keratitis is a severe fungal infection of the cornea.
  • It is challenging to treat, often progressing to endophthalmitis.
  • Standard antifungal therapies frequently fail, necessitating alternative treatments.

Observation:

  • Three patients with refractory Fusarium keratitis, including two with endophthalmitis, were identified.
  • These patients had failed maximal medical and surgical therapy, including voriconazole.
  • Two patients were contact lens wearers.

Findings:

  • All three patients received systemic posaconazole.
  • Posaconazole treatment led to rapid reduction in ocular inflammation and pain.
  • Complete resolution of Fusarium keratitis and/or endophthalmitis was achieved in all patients.

Implications:

  • Systemic posaconazole is a viable and effective treatment for pan-resistant Fusarium ocular infections.
  • Posaconazole's efficacy suggests its potential for treating deep-seated fungal infections due to its tissue penetration.
  • This finding provides a crucial therapeutic alternative for patients with severe, refractory fungal keratitis and endophthalmitis.

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