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Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis
A 30-year-old Bangladeshi gentleman presented with history of sand entering his left eye and was diagnosed as having fungal keratitis by private ophthalmologist. He was treated with three doses of conventional subconjunctival amphotericin B injections (1.5 mg of amphotericin B and 1.2 mg of deoxycho...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820660/ https://www.ncbi.nlm.nih.gov/pubmed/31695999 http://dx.doi.org/10.7759/cureus.5580 |
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author | Han Shu, Tham Hussein, Adil Kursiah, Mohd Razali |
author_facet | Han Shu, Tham Hussein, Adil Kursiah, Mohd Razali |
author_sort | Han Shu, Tham |
collection | PubMed |
description | A 30-year-old Bangladeshi gentleman presented with history of sand entering his left eye and was diagnosed as having fungal keratitis by private ophthalmologist. He was treated with three doses of conventional subconjunctival amphotericin B injections (1.5 mg of amphotericin B and 1.2 mg of deoxycholate) over the inferior bulbar conjunctiva and topical antibiotics. Subsequently, he developed conjunctival necrosis over the site of injections and there was no clinical improvement of the keratitis. He was then treated with intensive antifungal and antibiotics eye drops. Debridement of epithelial plug was done and he was given intracameral amphotericin B injection. There was gradual improvement observed then with conjunctival epithelialization. The conjunctival tissue was completely healed after three months along with the corneal ulcer. Subconjunctival injection of Amphotericin B (AMB) may be considered as an adjunct therapy in severe fungal keratitis to address the issue of compliance. Close monitoring is needed due to its known complication of scleritis, scleral thinning and conjunctival necrosis. Liposomal AMB which is known to cause less toxicity given via subconjunctival injection in human subjects needs to be further studied. |
format | Online Article Text |
id | pubmed-6820660 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-68206602019-11-06 Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis Han Shu, Tham Hussein, Adil Kursiah, Mohd Razali Cureus Ophthalmology A 30-year-old Bangladeshi gentleman presented with history of sand entering his left eye and was diagnosed as having fungal keratitis by private ophthalmologist. He was treated with three doses of conventional subconjunctival amphotericin B injections (1.5 mg of amphotericin B and 1.2 mg of deoxycholate) over the inferior bulbar conjunctiva and topical antibiotics. Subsequently, he developed conjunctival necrosis over the site of injections and there was no clinical improvement of the keratitis. He was then treated with intensive antifungal and antibiotics eye drops. Debridement of epithelial plug was done and he was given intracameral amphotericin B injection. There was gradual improvement observed then with conjunctival epithelialization. The conjunctival tissue was completely healed after three months along with the corneal ulcer. Subconjunctival injection of Amphotericin B (AMB) may be considered as an adjunct therapy in severe fungal keratitis to address the issue of compliance. Close monitoring is needed due to its known complication of scleritis, scleral thinning and conjunctival necrosis. Liposomal AMB which is known to cause less toxicity given via subconjunctival injection in human subjects needs to be further studied. Cureus 2019-09-05 /pmc/articles/PMC6820660/ /pubmed/31695999 http://dx.doi.org/10.7759/cureus.5580 Text en Copyright © 2019, Han Shu et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Ophthalmology Han Shu, Tham Hussein, Adil Kursiah, Mohd Razali Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis |
title | Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis |
title_full | Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis |
title_fullStr | Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis |
title_full_unstemmed | Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis |
title_short | Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis |
title_sort | conjunctiva necrosis following subconjunctival amphotericin b injection in fungal keratitis |
topic | Ophthalmology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820660/ https://www.ncbi.nlm.nih.gov/pubmed/31695999 http://dx.doi.org/10.7759/cureus.5580 |
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