Beauveria bassiana keratitis in bullous keratopathy: antifungal sensitivity testing and management
| Autor: | Luís Torrão, Luís Figueira, Raúl Moreira, Dolores Pinheiro, Jorge Palmares, Joana Simões, Eugénia Pinto, Elisa Camisa, Fernando Falcão-Reis |
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| Rok vydání: | 2012 |
| Předmět: |
Antifungal Agents
Visual Acuity Virulence Beauveria bassiana Microbial Sensitivity Tests Bassiana Keratitis Microbiology 03 medical and health sciences 0302 clinical medicine Drug Resistance Fungal medicine Humans Fungal keratitis Beauveria Corneal Ulcer DNA Fungal Aged biology business.industry fungi General Medicine Eye infection medicine.disease biology.organism_classification Ophthalmology Mycoses 030221 ophthalmology & optometry Bullous keratopathy Female business Eye Infections Fungal Keratoplasty Penetrating 030217 neurology & neurosurgery |
| Zdroj: | European Journal of Ophthalmology. 22:814-818 |
| ISSN: | 1724-6016 1120-6721 |
| DOI: | 10.5301/ejo.5000152 |
| Popis: | Beauveria bassiana is a ubiquitous fungus available as an insecticide. In humans, it has limited virulence; to our knowledge, only 3 cases of invasive disease and 10 cases of keratitis have been documented.We report the first case of B bassiana keratitis in a patient with aphakic bullous keratopathy. The fungal keratitis proved to be highly resistant to topical clotrimazole. Molecular identification was based on DNA sequence analysis. The minimal inhibitory concentrations (MIC) obtained were 2 µg/mL for voriconazole, 0.250 µg/mL for posaconazole, and128 µg/mL for fluconazole; amphotericin B MIC was16 µg/mL. In the absence of clinical improvement, a penetrating keratoplasty (PK) was performed. The patient was discharged on topical and systemic voriconazole and prednisolone 40 mg PO/day. The eye remained calm with a transparent cornea and clear anterior chamber.B bassiana keratitis is extremely rare, with only a few cases reported. Its risk factors are unknown. We report the first case in a patient with aphakic bullous keratopathy, which proved highly resistant to antifungal therapy (antifungal susceptibility results are presented). A PK was necessary for clinical improvement. A review of the literature is performed in an effort to define therapeutic strategies. |
| Databáze: | OpenAIRE |
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