Multidrug resistant Fusarium keratitis
P Antequera1, V Garcia-Conca2, C Martín-González1
1Servicio de Microbiología, Hospital Universitario San Juan, Alicante, España.
Case Report:
We report a case of keratitis in a female contact lens wearer, who developed a deep corneal abscess. The culture of a corneal biopsy scraping was positive for multiresistant Fusarium solani. The patient has a complicated clinical course and failed to respond to local and systemic antifungal treatment, requiring eye enucleation.
Conclusion:
Fusarium keratitis may progress to severe endophthalmitis. Clinical suspicion is paramount in order to start antifungal therapy without delay. Therapy is complex due to the high resistance of this organism to usual antifungal drugs.
Insights
Multiresistant Fusarium solani caused severe keratitis in a contact lens wearer, leading to corneal abscess and requiring eye enucleation despite antifungal treatment. Early diagnosis and aggressive therapy are crucial for managing this resistant fungal infection.
Area of Science:
- Ophthalmology
- Medical Mycology
Background:
- Contact lens wear is a significant risk factor for microbial keratitis.
- Fusarium species are common causes of fungal keratitis, particularly in tropical and subtropical regions.
Observation:
- A contact lens wearer presented with a deep corneal abscess.
- Corneal biopsy cultures identified a multiresistant strain of Fusarium solani.
Findings:
- The patient experienced a complicated clinical course with poor response to standard antifungal treatments.
- Despite aggressive local and systemic antifungal therapy, the infection progressed, necessitating enucleation.
Implications:
- Fusarium keratitis can lead to severe outcomes, including endophthalmitis and vision loss.
- The high resistance of some Fusarium strains to conventional antifungal drugs complicates treatment strategies.
- Prompt clinical suspicion and initiation of appropriate antifungal therapy are critical for successful management of fungal keratitis.
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