Keratomycosis due to Tintelnotia destructans refractory to common therapy treated successfully with systemic and local terbinafine in combination with polyhexamethylene biguanide.

Autor: Behrens-Baumann WJ; Department of Ophthalmology, Otto von Guericke University, Magdeburg, Germany., Hofmüller W; Department of Ophthalmology, Otto von Guericke University, Magdeburg, Germany., Tammer I; Department of Medical Microbiology, Otto von Guericke University, Magdeburg, Germany., Tintelnot K; Mycotic and Parasitic Agents and Mycobacteria, Robert Koch-Institute, Nordufer 20, 13353, Berlin, Germany. tintelnotk@rki.de.
Jazyk: angličtina
Zdroj: International ophthalmology [Int Ophthalmol] 2019 Jun; Vol. 39 (6), pp. 1379-1385. Date of Electronic Publication: 2018 Apr 28.
DOI: 10.1007/s10792-018-0930-2
Abstrakt: Purpose: To report on a wearer of rigid gas-permeable contact lenses with a keratomycosis due to Tintelnotia-a new genus of Phaeosphaeriaceae-treated with terbinafine and polyhexamethylene biguanide.
Methods: Chart review of a patient with fungal keratitis treated additionally with systemic and topical terbinafine 0.25% after symptoms increased under conventional antimycotic therapy with voriconazole. Antifungal susceptibility had been tested in vitro.
Results: After starting an additional treatment with systemic and topical terbinafine, the severe corneal infection was sufficiently resolved. The drug was well tolerated without any neurological, dermatological or gastroenterological problems. Terbinafine revealed a marked in vitro antifungal activity of 0.12 µg/ml. The fungus was identified as Tintelnotia destructans.
Conclusions: Terbinafine might be considered as a therapeutic option in severe cases of fungal keratitis refractory to common antifungal therapy.
Databáze: MEDLINE
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