Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole

Aim. To report a case of refractory fungal keratitis caused by Scedosporium apiospermum. Methods. Interventional case report. Results. A 47-year-old Malay housewife presented with left eye cornea ulcer as her first presentation of diabetes mellitus. There was no history of ocular trauma, contact len...

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Main Authors: Mohd-Tahir Fadzillah, Siti-Raihan Ishak, Mohtar Ibrahim
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2013/413953
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author Mohd-Tahir Fadzillah
Siti-Raihan Ishak
Mohtar Ibrahim
author_facet Mohd-Tahir Fadzillah
Siti-Raihan Ishak
Mohtar Ibrahim
author_sort Mohd-Tahir Fadzillah
collection DOAJ
description Aim. To report a case of refractory fungal keratitis caused by Scedosporium apiospermum. Methods. Interventional case report. Results. A 47-year-old Malay housewife presented with left eye cornea ulcer as her first presentation of diabetes mellitus. There was no history of ocular trauma, contact lens used, or cornea foreign body. Scedosporium apiospermum was isolated from the cornea scrapping. Her cornea ulcer initially responded well to topical Amphotericin B within 3 days but subsequently worsened. Repeat cornea scrapping also yields Scedosporium apiospermum. This refractory keratitis was successfully treated with a combination of topical Amphotericin B and Voriconazole over 6 weeks. Conclusion. Scedosporium apiospermum keratitis is an opportunistic infection, which is difficult to treat despite tight control of diabetes mellitus and intensive antifungal treatment. The infection appeared to have very quick onset but needed long duration of treatment to completely heal. Surgical debridement always plays an important role as a therapeutic procedure as well as establishes the diagnosis through repeat scrapping.
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institution Kabale University
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series Case Reports in Ophthalmological Medicine
spelling doaj-art-d4a1ce96b3024204803f69955606dfa92025-02-03T01:00:49ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302013-01-01201310.1155/2013/413953413953Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and VoriconazoleMohd-Tahir Fadzillah0Siti-Raihan Ishak1Mohtar Ibrahim2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, MalaysiaDepartment of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, MalaysiaDepartment of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, MalaysiaAim. To report a case of refractory fungal keratitis caused by Scedosporium apiospermum. Methods. Interventional case report. Results. A 47-year-old Malay housewife presented with left eye cornea ulcer as her first presentation of diabetes mellitus. There was no history of ocular trauma, contact lens used, or cornea foreign body. Scedosporium apiospermum was isolated from the cornea scrapping. Her cornea ulcer initially responded well to topical Amphotericin B within 3 days but subsequently worsened. Repeat cornea scrapping also yields Scedosporium apiospermum. This refractory keratitis was successfully treated with a combination of topical Amphotericin B and Voriconazole over 6 weeks. Conclusion. Scedosporium apiospermum keratitis is an opportunistic infection, which is difficult to treat despite tight control of diabetes mellitus and intensive antifungal treatment. The infection appeared to have very quick onset but needed long duration of treatment to completely heal. Surgical debridement always plays an important role as a therapeutic procedure as well as establishes the diagnosis through repeat scrapping.http://dx.doi.org/10.1155/2013/413953
spellingShingle Mohd-Tahir Fadzillah
Siti-Raihan Ishak
Mohtar Ibrahim
Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole
Case Reports in Ophthalmological Medicine
title Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole
title_full Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole
title_fullStr Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole
title_full_unstemmed Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole
title_short Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole
title_sort refractory scedosporium apiospermum keratitis successfully treated with combination of amphotericin b and voriconazole
url http://dx.doi.org/10.1155/2013/413953
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AT sitiraihanishak refractoryscedosporiumapiospermumkeratitissuccessfullytreatedwithcombinationofamphotericinbandvoriconazole
AT mohtaribrahim refractoryscedosporiumapiospermumkeratitissuccessfullytreatedwithcombinationofamphotericinbandvoriconazole