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Aspergillus terreus recovered from a corneal scraping
Summary
A severe fungal eye infection caused by Aspergillus terreus was successfully treated with voriconazole eyedrops. This case highlights the importance of prompt diagnosis and targeted antifungal therapy for fungal keratitis.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- A healthy 52-year-old male presented with eye irritation and redness after a foreign body removal.
- Initial treatment with vigamox and systane did not resolve symptoms, leading to referral.
Observation:
- The patient developed increased redness, vision loss, and yellow discharge within 48 hours.
- Ophthalmological examination revealed a central corneal infiltrate, haze, edema, conjunctival injection, and hypopyon.
Findings:
- Corneal scrapings identified Aspergillus terreus as the causative fungal agent.
- Elevated minimum inhibitory concentration (MIC) to amphotericin B (> 2 microg/mL) indicated potential treatment failure with that agent.
- Treatment with voriconazole eyedrops for 10 weeks was initiated.
Implications:
- Prompt laboratory identification of the fungal species and its sensitivities is crucial for effective treatment.
- Targeted antifungal therapy, such as voriconazole, is essential for managing Aspergillus keratitis.
- Photo-therapeutic keratectomy (PTK) may be necessary to address residual corneal scarring after infection resolution.
