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Exophiala jeanselmei keratitis
1Department of Pathology, College of Medicine, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Mycoses
|March 1, 1993
Summary
A fungal corneal abscess caused by Exophiala jeanselmei in a Saudi male was successfully treated with antifungal medications and surgical interventions. Vision improved significantly, with no recurrence after two years.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal keratitis presents a significant challenge in ophthalmology, particularly in tropical and subtropical regions.
- Dematiaceous fungi, such as Exophiala jeanselmei, can cause severe corneal infections.
- Early diagnosis and appropriate treatment are crucial to prevent vision loss.
Observation:
- A 42-year-old Saudi male presented with a fungal corneal abscess in his left eye.
- The causative agent was identified as Exophiala jeanselmei, a dematiaceous fungus.
- The infection led to corneal perforation and secondary glaucoma.
Findings:
- The patient received a combination of topical antifungal agents: natamycin, miconazole, and amphotericin B.
- Corneal perforation was managed with cyanocrylate glue.
- Peripheral anterior synechia-induced glaucoma required trabeculectomy.
- Successful eradication of the fungal infection was achieved.
- Visual acuity improved from counting fingers to 20/80.
Implications:
- This case highlights the importance of prompt and aggressive management of fungal keratitis.
- Multifaceted treatment strategies involving antifungals and surgical interventions are effective.
- Exophiala jeanselmei infections, though severe, can be successfully treated with good visual outcomes.
- Long-term follow-up is essential to monitor for recurrence and manage complications.