Aspergillus flavus Keratitis After Penetrating Keratoplasty
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View abstract on PubMed
Summary
This summary is machine-generated.A rare fungal keratitis caused by Aspergillus flavus occurred three months after corneal transplant surgery. Despite aggressive treatment, the infection progressed, requiring further surgery, but vision stabilized post-operatively.
Area Of Science
- Ophthalmology
- Infectious Diseases
Background
- Fungal keratitis is a severe complication after penetrating keratoplasty (PKP).
- This case details Aspergillus flavus keratitis presenting three months post-PKP in a patient with Fuchs' endothelial dystrophy.
Observation
- The patient developed pain, redness, discharge, and decreased vision with graft haze and stromal infiltrates.
- Corneal scrapings confirmed Aspergillus flavus; however, cultures from donor and recipient tissue were negative.
- The infection was presumed to be a postoperative superinfection due to delayed onset and a persistent epithelial defect.
Findings
- Aggressive topical and systemic antifungal therapy (voriconazole, amphotericin B) was initiated empirically.
- Despite treatment, the infection led to graft melting and corneal perforation, necessitating therapeutic PKP and vitrectomy.
- Removal of the intraocular lens and subsequent aphakia management stabilized the infection without recurrence.
Implications
- This case underscores the virulence of Aspergillus flavus in post-keratoplasty fungal keratitis.
- Challenges in management include delayed diagnosis and the need for prompt medical and surgical intervention.
- Predisposing factors like epithelial defects and corticosteroid use require careful consideration.
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