Surgical approach in a pregnant woman with corneal infection caused by fusarium
First Author: H.Tapia Quijada SPAIN
Co Author(s): S. Gomez Perera
We report the case of a pregnant woman who presented Fusarium keratitis refractory to treatment with topical and systemic antifungal agents, eventually requiring penetrating keratoplasty
Hospital Universitario de Canarias
41-year-old pregnant of 30 weeks, user of contact lens.Present pain, redness and blurred vision of his right eye (RE).visual acuity (VA) 0.3 and paracentral pseudodentritic corneal injury , which did not improve with topical antiviral treatment. Cultures were taken and empirical treatment with Ceftazidime and Oftacilox schedule was started . Positive microbiological result is received for Fusarium resistant to Voriconazole. It is done debridement of the lesion and epithelium to favor penetration of antifungals and assessing risk benefit begins Amphotericin B and topical Natamycin After 20 days of evolution, the evolution was torpid, and Penetrating Keratoplasty(PK) was performed of urgency. . As part of Follow-up was performed confocal microscopy and at 2 months of evolution without signs of recurrence of the fungal infection. Currently, one year after evolution, it presents a clear corneal button with a VA of 0.5
In any fungal infection, prompt diagnosis and treatment are critical for controlling the disease. If there is poor patient progress despite antifungal treatment, keratoplasty should be performed as soon as possible to prevent scleral invasion or its spread inside the eye, since when this happens, the possibilities of controlling the infection and visual recovery are very poor.