Keratitis Caused by Paecilomyces lilacinus after Cataract Surgery in a Patient with Systemic and Autoimmune Disease
Journal of the Korean Ophthalmological Society
; : 1795-1800, 2016.
Article
em Ko
| WPRIM
| ID: wpr-159675
Biblioteca responsável:
WPRO
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.
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Texto completo:
1
Índice:
WPRIM
Assunto principal:
Artrite Reumatoide
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Prognóstico
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Recidiva
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Doenças Autoimunes
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Esteroides
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Suturas
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Catarata
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Paecilomyces
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Acuidade Visual
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Edema da Córnea
Tipo de estudo:
Prognostic_studies
Limite:
Aged
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Female
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Humans
Idioma:
Ko
Revista:
Journal of the Korean Ophthalmological Society
Ano de publicação:
2016
Tipo de documento:
Article