Cargando…
Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen
PURPOSE: To describe a case of fungal keratitis involving an atypical organism with confirmatory in vivo confocal microscopy and to review the literature on Rhodotorula keratitis. METHODS: Case report and review of the medical literature. RESULTS: A 22-year-old college student was struck in the left...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224248/ https://www.ncbi.nlm.nih.gov/pubmed/25408670 http://dx.doi.org/10.1159/000365986 |
_version_ | 1782343320395055104 |
---|---|
author | Giovannini, Joseph Lee, Rick Zhang, Sean X. Jun, Albert S. Bower, Kraig S. |
author_facet | Giovannini, Joseph Lee, Rick Zhang, Sean X. Jun, Albert S. Bower, Kraig S. |
author_sort | Giovannini, Joseph |
collection | PubMed |
description | PURPOSE: To describe a case of fungal keratitis involving an atypical organism with confirmatory in vivo confocal microscopy and to review the literature on Rhodotorula keratitis. METHODS: Case report and review of the medical literature. RESULTS: A 22-year-old college student was struck in the left eye with a tree branch and subsequently developed pain, redness and photophobia. Upon presentation, visual acuity was 20/200 and there was a large epithelial defect with diffuse stromal inflammation involving the anterior one-third of the cornea. Cultures of the infiltrate were performed for bacterial, viral and fungal organisms that resulted in a positive culture for Rhodotorula mucilaginosa. Fungal elements were confirmed in vivo by confocal microscopy. The patient was treated with voriconazole initially and had amphotericin added once Rhodotorula infection was confirmed. The patient responded well clinically, and one month after therapy was initiated, the corneal infiltrate had resolved leaving mild anterior stromal haze. Upon completion of therapy at three months, the patient was asymptomatic, had a clear cornea and had a best corrected visual acuity of 20/20 in the involved eye. There was no measurable change in his manifest refraction. CONCLUSIONS: Prior cases of Rhodotorula keratitis most often required surgical intervention and were associated with poor outcomes. This case shows that Rhodotorula keratitis can be successfully treated with topical antifungal agents if diagnosed early and appropriate treatment is initiated promptly. We report the first case of Rhodotorula keratitis confirmed by in vivo confocal microscopy. This is also the first description of pseudomycelium formation that has not been previously described in vivo, a morphological structure that this organism rarely demonstrates. Finally, this case shows that confocal microscopy may aid in the early diagnosis and management of fungal keratitis involving this rare but potentially damaging organism. |
format | Online Article Text |
id | pubmed-4224248 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-42242482014-11-18 Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen Giovannini, Joseph Lee, Rick Zhang, Sean X. Jun, Albert S. Bower, Kraig S. Case Rep Ophthalmol Published online: October, 2014 PURPOSE: To describe a case of fungal keratitis involving an atypical organism with confirmatory in vivo confocal microscopy and to review the literature on Rhodotorula keratitis. METHODS: Case report and review of the medical literature. RESULTS: A 22-year-old college student was struck in the left eye with a tree branch and subsequently developed pain, redness and photophobia. Upon presentation, visual acuity was 20/200 and there was a large epithelial defect with diffuse stromal inflammation involving the anterior one-third of the cornea. Cultures of the infiltrate were performed for bacterial, viral and fungal organisms that resulted in a positive culture for Rhodotorula mucilaginosa. Fungal elements were confirmed in vivo by confocal microscopy. The patient was treated with voriconazole initially and had amphotericin added once Rhodotorula infection was confirmed. The patient responded well clinically, and one month after therapy was initiated, the corneal infiltrate had resolved leaving mild anterior stromal haze. Upon completion of therapy at three months, the patient was asymptomatic, had a clear cornea and had a best corrected visual acuity of 20/20 in the involved eye. There was no measurable change in his manifest refraction. CONCLUSIONS: Prior cases of Rhodotorula keratitis most often required surgical intervention and were associated with poor outcomes. This case shows that Rhodotorula keratitis can be successfully treated with topical antifungal agents if diagnosed early and appropriate treatment is initiated promptly. We report the first case of Rhodotorula keratitis confirmed by in vivo confocal microscopy. This is also the first description of pseudomycelium formation that has not been previously described in vivo, a morphological structure that this organism rarely demonstrates. Finally, this case shows that confocal microscopy may aid in the early diagnosis and management of fungal keratitis involving this rare but potentially damaging organism. S. Karger AG 2014-10-02 /pmc/articles/PMC4224248/ /pubmed/25408670 http://dx.doi.org/10.1159/000365986 Text en Copyright © 2014 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions. |
spellingShingle | Published online: October, 2014 Giovannini, Joseph Lee, Rick Zhang, Sean X. Jun, Albert S. Bower, Kraig S. Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen |
title | Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen |
title_full | Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen |
title_fullStr | Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen |
title_full_unstemmed | Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen |
title_short | Rhodotorula Keratitis: A Rarely Encountered Ocular Pathogen |
title_sort | rhodotorula keratitis: a rarely encountered ocular pathogen |
topic | Published online: October, 2014 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224248/ https://www.ncbi.nlm.nih.gov/pubmed/25408670 http://dx.doi.org/10.1159/000365986 |
work_keys_str_mv | AT giovanninijoseph rhodotorulakeratitisararelyencounteredocularpathogen AT leerick rhodotorulakeratitisararelyencounteredocularpathogen AT zhangseanx rhodotorulakeratitisararelyencounteredocularpathogen AT junalberts rhodotorulakeratitisararelyencounteredocularpathogen AT bowerkraigs rhodotorulakeratitisararelyencounteredocularpathogen |