Successful Treatment ofPaecilomyces lilacinusEndophthalmitis After Foreign Body Trauma to the Cornea
作者:
Yuval Domniz,
Michael Lawless,
Gerard Sutton,
Christopher Rogers,
Linthon Meagher,
期刊:
Cornea
(OVID Available online 2001)
卷期:
Volume 20,
issue 1
页码: 109-111
ISSN:0277-3740
年代: 2001
出版商: OVID
关键词: Pecilomyces Lilacinus;Endophthalmitis;Natamycin;Fluconazole;Amphotericin B
数据来源: OVID
摘要:
Purpose.To report the successful treatment of a patient withPaecilomyces lilacinusendophthalmitis infection after foreign body (FB) trauma to the cornea.Methods.A 30-year-old man presented to us with a corneal abscess and iritis 2 months after removal of a metal corneal FB. Initial corneal biopsy culture was negative. Treatment with topical 5% natamycin, 0.9% fortified gentamycin, and 5% cephalothin hourly was commenced. As a result of developing signs of endophthalmitis, two more biopsies were taken, a week apart, from the vitreous and anterior chamber, successively. The last biopsy yielded positive microbiologic results of the speciousPaecilomyces lilacinus. Intravitreal injection of 50 &mgr;g/0.5 mL of amphotericin was administered during the vitreal biopsy. Soon after isolating the speciousPaecilomyces lilacinus, the following treatment was administered: 200 mg of itraconazole bd by mouth, 5% topical natamycin every hour, 2 mg/mL of topical fluconazole every 2 hours, three anterior chamber injections of 0.35 mL of 0.1% fluconazole and two amphotericin B injections to the anterior chamber of 50 &mgr;g/0.5 mL each.Results.There appeared to be no sign of infection 6 months after initial treatment. A large, dense scar existed in the medial part of the cornea only. The pupil was secluded. The patient's visual acuity was 6/21. The eye was comfortable and all topical antifungal medication was ceased.
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