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Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report

Objective. To present a case of Drechslera spp. keratitis treated with topical Voriconazole. Method. A case report. Results. A 52-year-old diabetic male presented with a one-week history of foreign body sensation of the left eye, self-medicated with Neomycin, Polymyxin B, and Dexamethasone eye drops...

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Autores principales: Echavez, Margarita I., Agahan, Archimedes Lee D., Carino, Noel S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789358/
https://www.ncbi.nlm.nih.gov/pubmed/24151572
http://dx.doi.org/10.1155/2013/626704
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author Echavez, Margarita I.
Agahan, Archimedes Lee D.
Carino, Noel S.
author_facet Echavez, Margarita I.
Agahan, Archimedes Lee D.
Carino, Noel S.
author_sort Echavez, Margarita I.
collection PubMed
description Objective. To present a case of Drechslera spp. keratitis treated with topical Voriconazole. Method. A case report. Results. A 52-year-old diabetic male presented with a one-week history of foreign body sensation of the left eye, self-medicated with Neomycin, Polymyxin B, and Dexamethasone eye drops, and was diagnosed to have bacterial conjunctivitis, which was treated with Levofloxacin drops. The patient developed a corneal opacity after 2 days and was initially seen with a visual acuity of counting fingers on the left eye, with a 3 mm central corneal ulcer with feathery borders. No hypopyon was noted. The right eye had a visual acuity of 20/20 and had unremarkable findings. Corneal scraping of the ulcer showed no organisms on Gram and Giemsa stain. Cultures were positive for Drechslera spp. and patient was started on Natamycin drops every 15 minutes, Atropine drops 3× a day, and Levofloxacin was continued every 4 hours. The ulcer increased to 4 mm, the infiltrates became deeper involving the midstroma, and there was appearance of a 2 mm hypopyon. Natamycin was shifted to Voriconazole eye drops every 15 minutes. There was note of a decrease in the size of the ulcer and clearing of the infiltrates with the new treatment regimen. Final visual acuity after 29 days of treatment was 20/40 with note of a slight corneal haze in the area of the previous ulcer. Conclusion. Voriconazole may be safe and effective in the treatment of Drechslera keratitis. There was no perforation and there was immediate decrease in the size of the ulcer. This is the first known case of Drechslera keratitis treated with Voriconazole eye drops in the Philippines.
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spelling pubmed-37893582013-10-22 Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report Echavez, Margarita I. Agahan, Archimedes Lee D. Carino, Noel S. Case Rep Ophthalmol Med Case Report Objective. To present a case of Drechslera spp. keratitis treated with topical Voriconazole. Method. A case report. Results. A 52-year-old diabetic male presented with a one-week history of foreign body sensation of the left eye, self-medicated with Neomycin, Polymyxin B, and Dexamethasone eye drops, and was diagnosed to have bacterial conjunctivitis, which was treated with Levofloxacin drops. The patient developed a corneal opacity after 2 days and was initially seen with a visual acuity of counting fingers on the left eye, with a 3 mm central corneal ulcer with feathery borders. No hypopyon was noted. The right eye had a visual acuity of 20/20 and had unremarkable findings. Corneal scraping of the ulcer showed no organisms on Gram and Giemsa stain. Cultures were positive for Drechslera spp. and patient was started on Natamycin drops every 15 minutes, Atropine drops 3× a day, and Levofloxacin was continued every 4 hours. The ulcer increased to 4 mm, the infiltrates became deeper involving the midstroma, and there was appearance of a 2 mm hypopyon. Natamycin was shifted to Voriconazole eye drops every 15 minutes. There was note of a decrease in the size of the ulcer and clearing of the infiltrates with the new treatment regimen. Final visual acuity after 29 days of treatment was 20/40 with note of a slight corneal haze in the area of the previous ulcer. Conclusion. Voriconazole may be safe and effective in the treatment of Drechslera keratitis. There was no perforation and there was immediate decrease in the size of the ulcer. This is the first known case of Drechslera keratitis treated with Voriconazole eye drops in the Philippines. Hindawi Publishing Corporation 2013 2013-09-18 /pmc/articles/PMC3789358/ /pubmed/24151572 http://dx.doi.org/10.1155/2013/626704 Text en Copyright © 2013 Margarita I. Echavez et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Echavez, Margarita I.
Agahan, Archimedes Lee D.
Carino, Noel S.
Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report
title Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report
title_full Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report
title_fullStr Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report
title_full_unstemmed Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report
title_short Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report
title_sort fungal keratitis caused by drechslera spp. treated with voriconazole: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789358/
https://www.ncbi.nlm.nih.gov/pubmed/24151572
http://dx.doi.org/10.1155/2013/626704
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