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Trichophyton Spp. fungal keratitis in 22 years old female contact lenses wearer.
Coll Antropol 2010; 34 Suppl 2:271-4CA

Abstract

Fungal keratitis represents one of the most difficult forms of microbial keratitis to diagnose and treat successfully. It is difficult to obtain correct diagnosis and topical antifungal preparations. Fungi can cause severe stromal necrosis and enter the anterior chamber by penetrating an intact Descemet membrane. The most common pathogens are filamentous fungi (Aspergillus and Fusarium spp.) and Candida albicans. The incidence of Trichophyton spp. keratitis is 5%. A 22 years old female contact lenses wearer after keratitis developed corneal melting syndrome, spontaneous perforation of the cornea and complicated cataract of the left eye. Conjunctival swab was sterile as well as first sample of corneal tissue and sample from the anterior chamber. Urgent therapeutic perforating keratoplasty (PK), was performed together with extracapsular cataract extraction and the implantation of the intraocular lens in the posterior chamber. The patient was treated with ciprofloxacin and diflucan (systemic therapy); with dexamethason and atropin (subconjunctivaly) and chlorhexidine, brolene, levofloxacin, polimyxin B, and dexamethason/neomycin (topically). Microbiology evaluation was performed once again following excisional biopsy of the intracameral portion of the lesion. The presence of Trichophyton spp. was finally confirmed. Itraconazole and garamycin were included in the systemic therapy. Corneal graft was clear for 17 days but decompensated 28 days after the PK. After two weeks microorganisms invaded the vitreous and caused endophthalmitis. Despite urgent pars plana vitrectomy patient developed endophthalmitis, lost light sensation and developed phthysis. Evisceration and the implantation of silicon prosthesis was done. Perforating keratoplasty is a method of choice in treating severe infectious keratitis unresponsive to conservative treatment but without the eradication of microorganisms it cannot restore the vision or save the eye. Trichophyton spp. may cause a severe disease of the anterior and posterior part of the eye which may finish with the lost of vision/eye. Prompt diagnosis and treatment of Trichophyton spp. keratitis are essential for a good visual outcome.

Authors+Show Affiliations

Eye Clinic Svjetlost, Zagreb, Croatia. ivana.mravicic@svjetlost.hrNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21302731

Citation

Mravicić, Ivana, et al. "Trichophyton Spp. Fungal Keratitis in 22 Years Old Female Contact Lenses Wearer." Collegium Antropologicum, vol. 34 Suppl 2, 2010, pp. 271-4.
Mravicić I, Dekaris I, Gabrić N, et al. Trichophyton Spp. fungal keratitis in 22 years old female contact lenses wearer. Coll Antropol. 2010;34 Suppl 2:271-4.
Mravicić, I., Dekaris, I., Gabrić, N., Romac, I., Glavota, V., & Sviben, M. (2010). Trichophyton Spp. fungal keratitis in 22 years old female contact lenses wearer. Collegium Antropologicum, 34 Suppl 2, pp. 271-4.
Mravicić I, et al. Trichophyton Spp. Fungal Keratitis in 22 Years Old Female Contact Lenses Wearer. Coll Antropol. 2010;34 Suppl 2:271-4. PubMed PMID: 21302731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trichophyton Spp. fungal keratitis in 22 years old female contact lenses wearer. AU - Mravicić,Ivana, AU - Dekaris,Iva, AU - Gabrić,Nikica, AU - Romac,Ivana, AU - Glavota,Vlade, AU - Sviben,Mario, PY - 2011/2/10/entrez PY - 2011/2/10/pubmed PY - 2011/3/5/medline SP - 271 EP - 4 JF - Collegium antropologicum JO - Coll Antropol VL - 34 Suppl 2 N2 - Fungal keratitis represents one of the most difficult forms of microbial keratitis to diagnose and treat successfully. It is difficult to obtain correct diagnosis and topical antifungal preparations. Fungi can cause severe stromal necrosis and enter the anterior chamber by penetrating an intact Descemet membrane. The most common pathogens are filamentous fungi (Aspergillus and Fusarium spp.) and Candida albicans. The incidence of Trichophyton spp. keratitis is 5%. A 22 years old female contact lenses wearer after keratitis developed corneal melting syndrome, spontaneous perforation of the cornea and complicated cataract of the left eye. Conjunctival swab was sterile as well as first sample of corneal tissue and sample from the anterior chamber. Urgent therapeutic perforating keratoplasty (PK), was performed together with extracapsular cataract extraction and the implantation of the intraocular lens in the posterior chamber. The patient was treated with ciprofloxacin and diflucan (systemic therapy); with dexamethason and atropin (subconjunctivaly) and chlorhexidine, brolene, levofloxacin, polimyxin B, and dexamethason/neomycin (topically). Microbiology evaluation was performed once again following excisional biopsy of the intracameral portion of the lesion. The presence of Trichophyton spp. was finally confirmed. Itraconazole and garamycin were included in the systemic therapy. Corneal graft was clear for 17 days but decompensated 28 days after the PK. After two weeks microorganisms invaded the vitreous and caused endophthalmitis. Despite urgent pars plana vitrectomy patient developed endophthalmitis, lost light sensation and developed phthysis. Evisceration and the implantation of silicon prosthesis was done. Perforating keratoplasty is a method of choice in treating severe infectious keratitis unresponsive to conservative treatment but without the eradication of microorganisms it cannot restore the vision or save the eye. Trichophyton spp. may cause a severe disease of the anterior and posterior part of the eye which may finish with the lost of vision/eye. Prompt diagnosis and treatment of Trichophyton spp. keratitis are essential for a good visual outcome. SN - 0350-6134 UR - https://www.unboundmedicine.com/medline/citation/21302731/Trichophyton_Spp__fungal_keratitis_in_22_years_old_female_contact_lenses_wearer_ L2 - https://medlineplus.gov/eyewear.html DB - PRIME DP - Unbound Medicine ER -