KMID : 0360220160570111795
|
|
Journal of the Korean Ophthalmological Society 2016 Volume.57 No. 11 p.1795 ~ p.1800
|
|
Keratitis Caused by Paecilomyces lilacinus after Cataract Surgery in a Patient with Systemic and Autoimmune Disease
|
|
Oh Shin-Yeop
Kang Hye-Sook Lee Chang-Kyu
|
|
Abstract
|
|
|
Purpose: To report a case of Paecilomyces lilacinus fungal keratitis after cataract surgery in a patient with chronic systemic and autoimmune disease who was treated with medical therapy and penetrating keratoplasty.
Case summary: A 72-year-old female was referred for decreased visual acuity and ocular pain in the left eye. She underwent cataract surgery in the left eye 1 month earlier and was treated for 2 weeks for corneal edema and stromal infiltration around the corneal suture. She had a chronic systemic disease with hypertension, hyperlipidemia, hepatitis C and rheumatoid arthritis. Suspecting infectious keratitis, the patient was instructed to stop applying topical and systemic steroids and use topical amphotericin B (0.15%) and moxifloxacin (0.5%). However, without improvement, amphotericin B (0.15%) and moxifloxacin (0.5%) were changed to natamycin (5%) and topical voriconazole (2%) and systemic voriconazole was added. However, her systemic status deteriorated and corneal melting developed, scleral graft implantation and amniotic membrane implantation were performed to prevent corneal perforation 6 weeks after the initial visit. Paecilomyces lilacinus was identified in culture at 7 weeks and penetrating keratoplasty was performed 12 weeks after the initial visit. After penetrating keratoplasty, corneal status was stable for 6 months and no signs of recurrence were observed.
Conclusions: In a patient with Paecilomyces lilacinus fungal keratitis and chronic systemic and autoimmune disease, penetrating keratoplasty showed good prognosis when the disease was refractory to topical and systemic antifungal agents.
|
|
KEYWORD
|
|
Fungal keratitis, Paecilomyces lilacinus, Penetrating keratoplasty, Voriconazole
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|