Indolent keratitis due to fungus of Malbranchea species. A case report.

Autor:	Bamahfouz AY; Department of Ophthalmology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.; Department of Ophthalmology, Security Forces Hospital, Makkah, Saudi Arabia.; Department of Ophthalmology, King Abdullah Medical City, Makkah, Saudi Arabia., Alsaidi AA; Department of Ophthalmology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia., Alharbi IJ; Department of Ophthalmology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia., Elsebaei EA; Department of Ophthalmology, Security Forces Hospital, Makkah, Saudi Arabia., Aldosari AM; Department of Ophthalmology, Ministry of National Guard Health Affairs, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia., Farahat AG; Department of Ophthalmology, Security Forces Hospital, Makkah, Saudi Arabia., Alhazmi RT; Department of Ophthalmology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2020 Nov 27; Vol. 60, pp. 606-609. Date of Electronic Publication: 2020 Nov 27 (Print Publication: 2020).
DOI:	10.1016/j.amsu.2020.11.065
Abstrakt:	Introduction: Keratitis caused by saprophytic fungi is on the rise in rural areas, often caused by ocular trauma with wooden objects. Early detection of causative organisms and sustained, supervised management can prevent visual disabilities. Case Presentation: A middle-aged patient from a rural, semi-arid region who presented with pain, redness, and a foreign-body sensation in his left eye resulting from a corneal ulcer induced by trauma from a wooden stick. Due to a history of uncontrolled diabetes and progression of his corneal lesions, he was admitted to our institution for treatment of infectious keratitis. Microbiological examination of corneal scrapings revealed thin, septate hyaline hyphae without conidia or conidiophores, and the patient was diagnosed with a fungal keratitis caused by a Malbranchea species. Though the patient initially responded to treatment with topical natamycin, his condition worsened. He was subsequently successfully treated with topical amphotericin B (1 mg/mL) twice hourly and systemic antifungals. Four months after discharge, the patient returned with symptom recurrence. Conclusion: We report the case of a patient with a Malbranchea species causing a rare and recurrent fungal keratitis with corneal infiltrates, subsequently cured by medical management with salvaging of his vision. In patients with a suspected fungal keratitis, early treatment is crucial and should be combined with tight glycemic control for as long as 6 months after presentation to avoid recurrence. Competing Interests: We know of no conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome. (© 2020 The Authors.)
Databáze:	MEDLINE
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