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Fungal keratitis caused by Scedosporium apiospermum: a report of two cases and review of treatment

Poster Details

First Author: J.da Saude Lourenco SPAIN

Co Author(s):    B. Garcia-Valcarcel Gonzalez   R. Yela Delgado   F. Alcantud Jimenez   L. Ibares Frias   C. Colliga Jimenez   R. Blanco Soler     

Abstract Details

Purpose:

To report our experience in two cases of keratitis caused by Scedosporium apiospermum and review the scientific and clinical data published concerning this subject.

Setting:

Hospital General Universitario Gregorio Mara�Ã�±�Ã�³n - Madrid, Spain.

Methods:

Two-case report and literature review.

Results:

A 19-year-old and a 27-year-old woman reported pain, redness and vision loss for less than 72 hours. Both patients wore soft contact lenses and both admitted not removing them while swimming in pools or showering in music festivals. Initial examination showed a 4.5 to 5.5 mm abscess. Treatment begun with fortified tobramycin and cefazolin and 24 hours later oral and topic voriconazole was added, after receiving the first impressions from our microbiology laboratory. Results were good in the first patient and in the second patient we performed a penetrating keratoplasty which today has a visual acuity of 0.8.

Conclusions:

Mycotic keratitis are a potential cause of blindness. Diagnoses and treatment choices are essential and should be based on clinical and laboratory findings. Typical risk factors are contact lenses, trauma or geographic region. These infections are a major challenge for ophthalmologists. Epithelium and stroma are usually compromised and early identification of the fungus is highly important. Systemic anti fungal therapy is recommended in large ulcers, hypopion or other anterior chamber abnormalities. Over the last years, systemic voriconazole has proven effective and safe and intracameral injection should also be considered. These cases show good results with this treatment.

Financial Disclosure:

NONE

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