[Fusarium keratitis and endophthalmitis treated by intravenous ambisome]

This is a case study of Fusarium keratitis progressing to endophthatmitis that was successfully treated with a tiposomal formulation of amphotericin B (AmBisome] and local natamycin 5%.

A 41-year-old man presented with a clinical picture of endophthalmitis following deep Fusarium solani keratitis. Treatment with natamycin 5% drops and intravenous amphotericin B 150 mg per day caused renal failure and did not alleviate the endophthalmitis. Therefore, intravenous amphotericin B was replaced with intravenous AmBisome, 300 mg per day, to a cumulative dosage of 5.4 g.

Both the endophthalmitis and keratitis were alleviated within several weeks after starting AmBisome treatment. No systemic toxicity was noted. The final ophthalmoLogic examination showed a paracentral corneal scar, and a satisfactory best corrected visual acuity of 20/40.

Due to their relatively low systemic toxicity, liposomal formulations of amphotericin B can be administered in higher doses than traditional unencapsulated ntravenous amphotericin B achieving higher concentrations in the target organ.