Treatment of resistant Paecilomyces lilacinus keratitis with topical voriconazole and oral itraconazole: a rare case report from Somalia.

Autor:	Mohamed HM; Department of Ophthalmology, Mogadishu-Somalia-Turkish Training and Research Hospital, Mogadishu, Somalia., Hassan IA; Department of Ophthalmology, Mogadishu-Somalia-Turkish Training and Research Hospital, Mogadishu, Somalia., Yussuf AA; Department of Ophthalmology, Mogadishu-Somalia-Turkish Training and Research Hospital, Mogadishu, Somalia., Nor YA; Department of Ophthalmology, Mogadishu-Somalia-Turkish Training and Research Hospital, Mogadishu, Somalia., Ahmed AA; Department of Ophthalmology, Mogadishu-Somalia-Turkish Training and Research Hospital, Mogadishu, Somalia., Roble AA; Department of Ophthalmology, Mogadishu-Somalia-Turkish Training and Research Hospital, Mogadishu, Somalia.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2024 Mar 06; Vol. 86 (4), pp. 2172-2175. Date of Electronic Publication: 2024 Mar 06 (Print Publication: 2024).
DOI:	10.1097/MS9.0000000000001925
Abstrakt:	Introduction and Importance: Paecilomyces species are rare fungi that are resistant to standard treatment and have increasing clinical relevance. The Purpureocillium lilacinum, formerly known as Paecilomyces lilacinus, has a unique sensitivity for the corneal surface. However, only a few cases have been documented globally. This case report presents the successful management of a patient with Paecilomyces lilacinus keratitis with topical voriconazole and oral itraconazole. Case Presentation: A 40-year-old woman came to our ophthalmology clinic complaining of right eye pain due to a severe corneal infection in her right eye. Corneal scraping and identification of the cultured pathogen were performed, which revealed Paecilomyces lilacinus. The corneal infection improved after being treated with hourly topical voriconazole (10 mg/ml) and oral traconozole. Clinical Discussion: Paecilomyces/Purpureocillium keratitis, which accounts for 5% of keratomycosis cases in tropical and subtropical areas, is extremely rare. It does not respond well to conventional antifungal treatment and frequently requires therapeutic surgery. Risk factors include wearing contact lenses, ocular trauma, ocular surgery, corticosteroids, and intraocular lens implantation. Conclusion: For the treatment of Paecilomyces lilacinus keratitis that is unresponsive to conventional antifungal medications, voriconazole may be helpful. Early organism detection and the appropriate therapy are necessary for the management of keratitis. Competing Interests: The authors do not have any conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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