Combination of intracameral and intrastromal voriconazole in the treatment of recalcitrant Acremonium fungal keratitis

Middle East Afr J Ophthalmol. Apr-Jun 2012;19(2):265-8. doi: 10.4103/0974-9233.95271.

Abstract

We present a report of a 28-year-old female with fungal keratitis due to Acremonium that was unresponsive to full medical therapy over 3 weeks. The patient was treated with superficial keratectomy, intrastromal and intracameral voriconazole injections. There was a marked clinical improvement beginning on day 3 post-therapy that was sustained until the last follow-up at 6 months. This is the first case of fungal keratitis due to Acremonium treated by a combination of intrastromal and intracameral voriconazole. This cost-effective treatment modality proved to be significant in impeding the progression of this potentially blinding disease and improving visual prognosis.

Keywords: Acremonium; Fungal keratitis; Intracameral Injection; Intrastromal Injection; Voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Acremonium / isolation & purification*
  • Adult
  • Anterior Chamber
  • Antifungal Agents / administration & dosage
  • Corneal Stroma / microbiology
  • Diagnosis, Differential
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / microbiology
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Keratitis / diagnosis
  • Keratitis / drug therapy*
  • Keratitis / microbiology
  • Pyrimidines / administration & dosage*
  • Triazoles / administration & dosage*
  • Voriconazole

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole