KMID : 0670820150200020027
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Korean Journal of Medical Mycology 2015 Volume.20 No. 2 p.27 ~ p.33
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A Case of Alternaria alternata Keratitis Isolated from Corneal Tissue
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Kang Kyoung-Min
Kim Hong-Kyun Lee Hae-Sook Song Kyung-Eun Lee Sang-Han Lee Weon-Ju Lee Won-Kil
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Abstract
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A 71-year-old man presented with pain in the left eye that revealed a 3¡¿3 mm deep corneal stromal infiltrate, with a 2¡¿2 mm epithelial defect. The patient started topical moxifloxacin, voriconazole 2%, and natamycin for 2 weeks. However, the treatment was not effective and the corneal infiltration worsened. Subsequently, the patient underwent therapeutic penetrating keratoplasty. Thick brown/gray mold colonies on Potato Corn Meal Tween 80 agar was isolated from excised corneal tissue and on slide culture many septated, and club-shaped ascospores were revealed. Histological findings also showed numerous hyphae scattered in corneal tissue. A. alternata colonies were confirmed by 18S rRNA sequencing. Intracameral voriconazole was injected every other day for 2 weeks to eliminate remaining fungi on the deep corneal stroma. The remaining corneal infiltration was improved one month after the injection. During 5 months postoperative follow up, the infection did not recurred. In conclusion, deep corneal infection of A. alternata was effectively treated with intracameral voriconazole injection.
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KEYWORD
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Alternaria alternata, Cornea culture, Intracameral voriconazole injection
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