A Case of Fungal Keratitis Caused by Drechslera Species

Che Ron Kim; Seong Wook Seo; Jong Moon Park; Ji Myung Yoo; Yong Seop Han; Sunjoo Kim; Seong Jae Kim

doi:10.3341/jkos.2011.52.11.1366

Journal List > J Korean Ophthalmol Soc > v.52(11) > 1008934

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Seo, Park, Yoo, Han, Kim, and Kim: A Case of Fungal Keratitis Caused by Drechslera Species

Original Article

J Korean Ophthalmol Soc 2011;52(11):1366-1369.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.11.1366

A Case of Fungal Keratitis Caused by Drechslera Species

Che Ron Kim, MD¹, Seong Wook Seo, MD, PhD^1,², Jong Moon Park, MD, PhD^1,², Ji Myung Yoo, MD, PhD^1,², Yong Seop Han, MD¹, Sunjoo Kim, MD, PhD³, Seong Jae Kim, MD¹

¹Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea

²Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea

³Department of Laboratory Medicine, Gyeongsang National University School of Medicine, Jinju, Korea

Address reprint requests to Seong Jae Kim, MD Department of Ophthalmology, Gyeongsang National University Hospital #92 Chiram-dong, Jinju 660-280, Korea Tel: 82-55-750-8170, Fax: 82-55-758-4158, E-mail: Maya12kim@naver.com

Received 25 November 2010 Revised 25 June 2011 Accepted 30 September 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of fungal keratitis caused by Drechslera species.

Case summary

A 77-year-old man visited our clinic complaining of left ocular pain and decrease of visual acuity for 1 week On slit-lamp examination, epithelial defect and stromal infiltration on the corneal center with numerous inflammatory cells in the anterior chamber were found. There was no improvement after routine antibiotic treatment. A corneal biopsy and culture were performed on the corneal lesion. The KOH smear study reported hyphae, thus the patient was treated with 0.25% amphotericin B, 0.2% fluconazole and 5% natamycin eye drops. A clinical improvement was observed on the corneal lesion and Drechslera species was identified by the culture study.

Conclusions

The authors report an experience of fungal keratitis caused by Drechslera species.

Keywords: Drechslera, Fungal keratitis, Natamycin

References

1. Leber TH. Keratomycosis aspergillina als ursache von hypopyonkeratitis. Graefes Arch Ophthalmol. 1879; 25:285–301.

2. Jurkunas U, Behlau I, Colby K. Fungal keratitis: Changing pathogens and risk factors. Cornea. 2009; 28:638–43.

3. Thomas PA. Fungal infections of the cornea. Eye. 2003; 17:852–62.

4. Rosa RH Jr, Miller D, Alfonso EC. The changing spectrum of fungal keratitis in south Florida. Ophthalmology. 1994; 101:1005–13.

5. Alfonso EC, Cantu-Dibildox J, Munir WM, et al. Insurgence of Fusarium keratitis associated with contact lens wear. Arch Ophthalmol. 2006; 124:941–7.

6. Bernal MD, Acharya NR, Lietman TM, et al. Outbreak of Fusarium keratitis in soft contact lens wearers in San Francisco. Arch Ophthalmol. 2006; 124:1051–3.

7. Afonso EC, Rosa RH, Miller D. Fungal Keratitis Cornea. 2nd ed.2. Philadelphia: Elsevier Mosby;2005. p. 1101–22.

8. Kim YK, Kim TY, Kim BC, et al. Clinical Mycology. 3rd ed.Seoul: Korea Medicine;2008. p. 202–3.

9. Seo JH, Wee WR, Lee JH, Kim MK. Risk factors affecting efficacy of intracameral amphotericin injection in deep keratomycosis. J Korean Ophthalmol Soc. 2007; 48:1202–11.

10. Tanure MA, Cohen EJ, Sudesh S, et al. Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea. 2000; 19:307–12.

11. Hahn YH, Lee DJ, Kim MS, et al. Epidemiology of fungal keratitis in Korea: A multicenter study. J Korean Ophthalmol Soc. 2000; 41:1499–508.

12. O'Day DM. Selection of appropriate antifungal therapy. Cornea. 1987; 6:238–45.

13. Srinivasan M. Fungal keratitis. Curr Opin Ophthalmol. 2004; 15:321–7.

14. O'Day DM, Head WS, Robinson RD, Clanton JA. Corneal penetration of Topical amphotericin B and natamycin. Curr Eye Res. 1986; 5:877–82.

15. Zapater RC, Albesi EJ, Garcia GH. Mycotic keratitis by Drechslera spicifera. Sabouraudia. 1975; 13:295–8.

16. Sundaram BM, Badrinath S, Subramanian S. Studies on mycotic keratitis. Mycoses. 1989; 32:568–72.

17. Fitzsimons R, Peters AL. Miconazole and ketoconazole as a satisfactory first-line treatment for keratomycosis. Am J Ophthalmol. 1986; 101:605–8.

18. Chander J, Sharma A. Prevalence of fungal corneal ulcers in Northern India. Infection. 1994; 22:207–9.

Figure 1.

On the first day the patient visited our clinic epithelial defect and corneal stromal infiltration is located in the center of the cornea. There is no hypopyon.

Figure 2.

Twenty days after first visit, epithelial defect, whitish elevated corneal lesion is detected. Stromal infiltration lesion has enlarged.

Figure 3.

Photograph of corneal biopsy specimen shows abundant hyphae (H&E, ×200).

Figure 4.

On the fifteenth hospital day, the lesion of the corneal stroma is clear. Hypopyon disappeared.

TOOLS

Similar articles