Complete cure of Fusarium solani sp. complex onychomycosis with Qs NdYAG treatment.

The incidence of non dermatophytic mould (NDM) onychomycosis (OM) has been steadily increasing Fusarium spp is the most common cause of NDM OM in most geographical locations. Fusarium spp and other NDMs are largely resistant to commonly used anti-fungals. The successful use of laser and light based devices has been demonstrated in dermatophytic OM, but there is no previous report of their successful use in any NDM OM. We describe a patient with OM caused by Fusarium solani spp, who was clinically (with a normal appearing nail) and mycologically (with negative microscopy and culture on repeated samples) cured of her infection following treatment with 2 sessions of Qs NdYAG (532nm and 1064nm) given 1 month apart.

Argon laser phototherapy in the treatment of refractory fungal keratitis.

PURPOSE: To report the beneficial properties of argon laser as an adjunctive therapy in 2 patients with refractory fungal keratitis. METHODS: Case reports and a review of the literature. Two cases of Fusarium keratitis refractory to topical and systemic antifungals were further treated with argon laser. Before laser treatment, the eye was medicated with proparacaine 0.5%, lidocaine 4%, and a single drop of fluorescein sodium 0.25%. Argon laser irradiation of the affected cornea was performed using argon blue-green wavelength (Coherent Ultima 2000; Coherent, Inc). A spot size of 500 µm, pulse duration of 0.10 seconds, and power ranging from 500 to 900 mW were used. RESULTS: During the first week after laser treatment, both patients showed complete resolution of the infiltrates. Two signs were observed during the procedure: a blanching of the corneal stroma and small cavitations that reached the middle stroma. No adverse effects were observed. CONCLUSIONS: Argon laser phototherapy is useful as an adjunctive treatment of refractory fungal keratitis. More cases are needed to validate our findings.