Pseudallescheria boydii Keratitis

Özkurt, Yelda Buyru; Oral, Yesim; Kulekci, Zeynep; Benzonana, Nur; Ustaoglu, Reyhan; Doğan, Ömer Kami̇l

doi:10.3928/0191-3913-20060201-14

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J Pediatr Ophthalmol Strabismus

2006

DOI: 10.3928/0191-3913-20060201-14

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Pseudallescheria boydii Keratitis

Yelda Buyru Özkurt¹,

Yesim Oral²,

Zeynep Kulekci³

et al.

Abstract: <p>Abstract. We describe a patient with Pseudallescheria boydii keratitis. The treatment of mycotic keratitis remains difficult. This case demonstrates that identification and susceptibility testing should be rapidly performed. In cases of indolent keratitis, the possibility of fungal infection should be kept in mind. J Pediatr Ophthalmol Strabismus 2006;43:114-115.</p>

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Cited by 3 publications

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Fungal keratitis caused by rare organisms

Tabatabaei

Soleimani

et al. 2018

Journal of Current Ophthalmology

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PurposeTo report two rare cases of filamentous fungal keratitis.MethodsTwo non-consecutive patients presented with suspicious fungal keratitis. After performing the smear and culture, medical therapy was started for them. They underwent slit photography and in vivo confocal microscopy (IVCM) in their follow-up visits.ResultsThe patients were 33-year-old and 56-year-old farmer men. They both mentioned a history of ocular trauma by plants. During their follow-up visits, corneal infiltration density and fungal hyphae density decreased in slit-lamp biomicroscopy and IVCM, respectively. The corresponding organisms were Pseudallescheria boydii (P. boydii) and Colletotrichum coccodes.ConclusionsIt is important to be aware of these rare organisms and their antibiotic susceptibility. There was not any specific confocal feature for the presented fungal keratitis that was different from other filamentous fungal hyphae; however, confocal scan is a good choice to follow the response to the treatment.

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Fungal keratitis caused by rare organisms

Tabatabaei

Soleimani

et al. 2018

Journal of Current Ophthalmology

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Pseudallescheria boydii Necrotizing Scleritis Treated with Several Antifungal Agents

Lee¹,

Kim²,

Lee³

et al. 2021

J Korean Ophthalmol Soc

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We report a case of post-pterygium excisional Pseudallescheria boydii (P. boydii) necrotizing scleritis successfully treated with multi-antifungal agents. Case summary: A 73-year-old female with a history of pterygium excision 6 years prior was referred to our institute because of worsening scleritis in the left eye during high-dose, 2-week steroid treatment. On the initial visit, an oval ulcer was observed in the temporal sclera adjacent to the limbus. All steroids were stopped and 1% voriconazole, 5% natamycin, 2.5% vancomycin, and 5% ceftazidime eyedrops were applied every hour and oral voriconazole 200 mg prescribed once a day, but the scleral necrosis continued to worsen. On day 10, the filamentous fungus P. boydii was isolated; 0.5% caspofungin eyedrops were added and the topical voriconazole concentration increased to 2%. Six weeks later, despite epithelization over the scleral necrosis, choroidal detachment developed. The antifungal treatment was continued and a dispersive, ophthalmic viscosurgical device inserted in the anterior chamber. At 14 weeks of treatment, the scleral necrosis was completely epithelialized and the choroidal detachment had disappeared. Conclusions: When encountering a case of P. boydii-caused necrotizing scleritis developing after pterygium excision surgery, long-term intensive treatment with several antifungal agents must be considered.

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Update on diagnosis and management of refractory corneal infections

Agarwal

Khan

Vanathi

et al. 2022

Indian Journal of Ophthalmology

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Infectious keratitis is a medical emergency resulting in significant visual morbidity. Indiscriminate use of antimicrobials leading to the emergence of resistant or refractory microorganisms has further worsened the prognosis. Coexisting ocular surface diseases, delay in diagnosis due to inadequate microbiological sample, a slow-growing/virulent organism, or systemic immunosuppressive state all contribute to the refractory response of the ulcer. With improved understanding of these varied ocular and systemic factors contributing to the refractory nature of the microbes, role of biofilm formation and recent research on improving the bioavailability of drugs along with the development of alternative therapies have helped provide the required multidimensional approach to effectively diagnose and manage cases of refractory corneal ulcers and prevent corneal perforations or further dissemination of disease. In this review, we explore the current literature and future directions of the diagnosis and treatment of refractory keratitis.

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Pseudallescheria boydii Keratitis

Cited by 3 publications

References 10 publications

Fungal keratitis caused by rare organisms

Fungal keratitis caused by rare organisms

Pseudallescheria boydii Necrotizing Scleritis Treated with Several Antifungal Agents

Update on diagnosis and management of refractory corneal infections

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