[Severe Aspergillus keratomycosis treated with itraconazole per os]

A case of deep traumatic keratomycosis due to Aspergillus fumigatus with anterior chamber involvement is reported. Corneal perforation was threatening because of the large deep and long standing ulcer. This case emphasizes the difficulties of etiological diagnosis and treatment of keratomycosis. The authors analyse the peculiarities of corneal mycotic abcess and emphasize the importance of corneal cultures; they discuss the most recent therapeutic protocols for these lesions. After a very poor response to conventional antifungal therapy, total and quick recovery was acquired using itraconazole per os and topical Amphotericine B. The efficiency of itraconazole proves its antifungal activity against Aspergillus fumigatus and its good penetration to the deeper layers of the cornea and of the anterior chamber.