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Aureobasidium Pullulans Keratitis Following Automated Lamellar Therapeutic Keratoplasty
Abstract:
Aureobasidium pullulans is a rare cause of fungal keratitis. A 73-year-old man underwent Automated Lamellar Therapeutic Keratoplasty (ALTK) for healed trachomatous keratopathy in his left eye. Five days later, he developed a graft infection. Cultures from corneal scraping showed findings consistent with Aureobasidium pullulans. The keratitis failed to respond to intensive topical and systemic anti-fungal therapy. Hence, the lamellar graft was removed. Despite this, the clinical condition deteriorated and a therapeutic penetrating keratoplasty had to be carried out to salvage the eye. At 1 year follow-up, there was no recurrence of infection. Graft infection with Aureobasidium pullulans may not be amenable to topical and systemic antifungal therapy and a penetrating keratoplasty may be required for control of infection.
Insights
A rare fungal keratitis caused by Aureobasidium pullulans after corneal transplanting did not respond to standard antifungal treatments. A penetrating keratoplasty was ultimately required to control the infection and save the patient's eye.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal keratitis is an infection of the cornea.
- Aureobasidium pullulans is an uncommon cause of fungal keratitis.
- Corneal transplantation, such as Automated Lamellar Therapeutic Keratoplasty (ALTK), is a procedure to restore vision.
Purpose of the Study:
- To report a case of fungal keratitis caused by Aureobasidium pullulans following ALTK.
- To discuss the treatment challenges and outcomes for this rare infection.
Main Methods:
- A 73-year-old male patient underwent ALTK for trachomatous keratopathy.
- Postoperative graft infection was diagnosed via corneal scraping cultures.
- The patient received intensive topical and systemic antifungal therapy.
- The infected lamellar graft was removed, followed by therapeutic penetrating keratoplasty.
Main Results:
- Cultures confirmed Aureobasidium pullulans as the causative agent of graft infection.
- The keratitis was refractory to standard antifungal treatments.
- Graft removal and subsequent penetrating keratoplasty were necessary to manage the infection.
- No recurrence of infection was observed at the 1-year follow-up.
Conclusions:
- Aureobasidium pullulans can cause severe fungal keratitis after corneal transplantation.
- Standard antifungal therapies may be insufficient for controlling this specific fungal infection.
- Penetrating keratoplasty may be a crucial intervention for managing refractory cases of Aureobasidium pullulans keratitis.
