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A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species

BACKGROUND: Fungal keratitis is difficult to treat that can result in corneal blindness requiring penetrating keratoplasty and in fungal endothalmitis. We report a case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton. CASE PRESENTATION: A 77-year old male presented with...

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Autores principales: Jin, Ki Won, Jeon, Hyun Sun, Hyon, Joon Young, Wee, Won Rynag, Suh, Wool, Shin, Young Joo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096410/
https://www.ncbi.nlm.nih.gov/pubmed/25015110
http://dx.doi.org/10.1186/1471-2415-14-90
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author Jin, Ki Won
Jeon, Hyun Sun
Hyon, Joon Young
Wee, Won Rynag
Suh, Wool
Shin, Young Joo
author_facet Jin, Ki Won
Jeon, Hyun Sun
Hyon, Joon Young
Wee, Won Rynag
Suh, Wool
Shin, Young Joo
author_sort Jin, Ki Won
collection PubMed
description BACKGROUND: Fungal keratitis is difficult to treat that can result in corneal blindness requiring penetrating keratoplasty and in fungal endothalmitis. We report a case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton. CASE PRESENTATION: A 77-year old male presented with ocular pain, conjunctival injection, and severe loss of vision in his left eye. His best corrected visual acuity was hand movements in the left eye, and slit-lamp examination showed a corneal ulcer with feathery margin and hypopyon. Bacterial and fungal smear/culture showed no organism, and there was no improvement in spite of treatment with topical fortified 5% cefazolin and 2% tobramycin. Trichophyton species was identified by repeated cultures. We found onychomycosis on the patient’s foot, where the same fungal species were identified. Regimen was changed to topical itraconazole and systemic intravenous itraconazole. No clinical improvement was observed, so therapeutic penetrating keratoplasty and cryotherapy was done with continuation of antifungal therapy. The graft was clear at postoperative 1 month and no evidence of recurrence was found. CONCLUSION: It is important to identify the pathogen of keratitis because early identification of pathogen causing keratitis provides the appropriate treatment in early phase of keratitis. It is necessary to search for other fungal skin infections such as onychomycosis and athelete’s foot considering the fungal keratitis following skin infection. In addition, fungal skin infection including onychomycosis should be treated for prevention of fungal keratitis as soon as possible.
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spelling pubmed-40964102014-07-15 A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species Jin, Ki Won Jeon, Hyun Sun Hyon, Joon Young Wee, Won Rynag Suh, Wool Shin, Young Joo BMC Ophthalmol Case Report BACKGROUND: Fungal keratitis is difficult to treat that can result in corneal blindness requiring penetrating keratoplasty and in fungal endothalmitis. We report a case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton. CASE PRESENTATION: A 77-year old male presented with ocular pain, conjunctival injection, and severe loss of vision in his left eye. His best corrected visual acuity was hand movements in the left eye, and slit-lamp examination showed a corneal ulcer with feathery margin and hypopyon. Bacterial and fungal smear/culture showed no organism, and there was no improvement in spite of treatment with topical fortified 5% cefazolin and 2% tobramycin. Trichophyton species was identified by repeated cultures. We found onychomycosis on the patient’s foot, where the same fungal species were identified. Regimen was changed to topical itraconazole and systemic intravenous itraconazole. No clinical improvement was observed, so therapeutic penetrating keratoplasty and cryotherapy was done with continuation of antifungal therapy. The graft was clear at postoperative 1 month and no evidence of recurrence was found. CONCLUSION: It is important to identify the pathogen of keratitis because early identification of pathogen causing keratitis provides the appropriate treatment in early phase of keratitis. It is necessary to search for other fungal skin infections such as onychomycosis and athelete’s foot considering the fungal keratitis following skin infection. In addition, fungal skin infection including onychomycosis should be treated for prevention of fungal keratitis as soon as possible. BioMed Central 2014-07-11 /pmc/articles/PMC4096410/ /pubmed/25015110 http://dx.doi.org/10.1186/1471-2415-14-90 Text en Copyright © 2014 Jin et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Jin, Ki Won
Jeon, Hyun Sun
Hyon, Joon Young
Wee, Won Rynag
Suh, Wool
Shin, Young Joo
A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species
title A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species
title_full A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species
title_fullStr A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species
title_full_unstemmed A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species
title_short A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species
title_sort case of fungal keratitis and onychomycosis simultaneously infected by trichophyton species
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096410/
https://www.ncbi.nlm.nih.gov/pubmed/25015110
http://dx.doi.org/10.1186/1471-2415-14-90
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