ABSTRACT
ABSTRACT Conjunctival ulceration accompanied with secretion and pain was observed in a 30-year-old male, 3 days after a perforating corneal trauma. Cultures of conjunctival ulcer samples grew Fonsecaea pedrosoi, a major causative agent of chromoblastomycosis that is typically transmitted during trauma. The conjunctival ulcer was successfully treated with amphotericin B, itraconazole, and fluconazole. This case report summarizes the diagnosis and treatment of a conjunctival ulcer due to F. pedrosoi, which is a rare complication of contaminated ocular trauma. To the best of our knowledge, this is the first reported case of F. pedrosoi causing acute conjunctival ulceration in the literature.
RESUMO O quadro clínico de uma úlcera conjuntival acompanhada de secreção e dor foi observado em homem de 30 anos de idade, 3 dias após um trauma perfurante da córnea. As culturas de uma amostra retirada da úlcera conjuntival foi positiva para Fonsecaea pedrosoi, uma cromoblastomicose, geralmente transmitido após traumatismos. O caso foi tratado com sucesso com a anfotericina B, itraconazol e fluconazol. Este relato de caso reporta o diagnóstico e tratamento de uma úlcera conjuntival causada por F. pedrosoi, que raramente é visto nos olhos expostos a traumatismos contaminados. Até onde sabemos, este é o primeiro caso relatado na literatura de F. pedrosoi causando úlcera conjuntival aguda.
Subject(s)
Humans , Male , Adult , Ascomycota/pathogenicity , Corneal Ulcer/microbiology , Chromoblastomycosis/microbiology , Conjunctival Diseases/microbiology , Corneal Perforation/microbiology , Ascomycota/isolation & purification , Corneal Ulcer/therapy , Chromoblastomycosis/therapy , Treatment Outcome , Conjunctival Diseases/therapy , Cornea/microbiology , Corneal Perforation/complications , Corneal Perforation/therapy , Antifungal Agents/therapeutic useABSTRACT
To examine the efficacy of amniotic membrane transplantation [AMI] in the treatment of perforated corneal ulcerations. Eighteen patients [18 eyes] with perforated corneal ulcers were treated with multilayered AMT. Separate amniotic membranes [AM] were transplanted as material to fill the stromal layer [AM filling], as a basement membrane [AM graft], and as a wound cover [AM patch]. The underlying causes of corneal perforation included herpes simples keratitis [6 eyes], mixed bacterial and fungal keratitis [4 eyes], bacterial keratitis [3 eyes], bullous keratopathy [3 eyes], and Moor en's ulcer [2 eyes]. During the follow up period of 16.7 +/- 7.2 months [8 - 21 months] after AMT, 13 [72.2%] of 18 eyes healed with a mean 27.2 +/- 9 epithelialization period of 18.3 +/- 6 days [range 11 to 32 days]. The remaining 5 eyes [27.8%] received second AMT, but disentgration of the amniotic membrane [AM] occurred and they received conjuntival flap. No patient developed major postoperative complications or graft rejection. Multilayer amniotic membrane transplantation can he used as an emergency treatment for perforated corneal ulcerations to restore corneal integrity so that emergency penetrating keratoplasty [PK] can be avoided