Rodrigo Mena1, Eduardo Carrasco1, Patricio Godoy-Martínez2, Alberto M Stchigel3, José F Cano-Lira4, Luis Zaror5. 1. Servicio de Oftalmología, Hospital Base de Valdivia, Valdivia, Chile. 2. Instituto de Microbiología Clínica, Universidad Austral de Chile, Valdivia, Chile. 3. Unidad de Micología, Facultad de Medicina y IISPV, Universitat Rovira i Virgili, Reus, Tarragona, España. 4. Unidad de Micología, Facultad de Medicina y IISPV, Universitat Rovira i Virgili, Reus, Tarragona, España. Electronic address: jose.cano@urv.cat. 5. Escuela de Tecnología Médica, Universidad Mayor, Sede Temuco, Temuco, Chile.
Abstract
BACKGROUND: Keratomycosis is one of the most prevalent ophthalmic infections, which needs a specific treatment depending on the nature of the infecting fungus. The prognosis is usually severe and depends on an early diagnosis and suitable therapy. CASE REPORT: We describe a case of keratitis due to Fusarium solani in a patient from a rural area, who, between May and October 2011, suffered a corneal trauma caused by dust particles in Valdivia, Chile. On two occasions, direct examination of eye scrapes revealed abundant septate hyphae. All cultures were positive for the same fungus, which was identified as Fusarium solani by phenotypic characterization and sequencing of ribosomal nuclear genes. The patient was initially treated with amphotericin B and afterwards successfully responded to a treatment with oral and intravenous voriconazole, although corneal opacity persisted. CONCLUSIONS: Although keratomycosis in Chile is rare, its diagnostic particularities must be taken into consideration to establish the most effective treatment. Thus, a rapid visualization of the fungus in the lesion, an efficient isolation of the etiologic agent in pure culture is essential, as well as its rapid identification, which requires the use of molecular sequencing techniques in the case of Fusarium species.
BACKGROUND: Keratomycosis is one of the most prevalent ophthalmic infections, which needs a specific treatment depending on the nature of the infecting fungus. The prognosis is usually severe and depends on an early diagnosis and suitable therapy. CASE REPORT: We describe a case of keratitis due to Fusarium solani in a patient from a rural area, who, between May and October 2011, suffered a corneal trauma caused by dust particles in Valdivia, Chile. On two occasions, direct examination of eye scrapes revealed abundant septate hyphae. All cultures were positive for the same fungus, which was identified as Fusarium solani by phenotypic characterization and sequencing of ribosomal nuclear genes. The patient was initially treated with amphotericin B and afterwards successfully responded to a treatment with oral and intravenous voriconazole, although corneal opacity persisted. CONCLUSIONS: Although keratomycosis in Chile is rare, its diagnostic particularities must be taken into consideration to establish the most effective treatment. Thus, a rapid visualization of the fungus in the lesion, an efficient isolation of the etiologic agent in pure culture is essential, as well as its rapid identification, which requires the use of molecular sequencing techniques in the case of Fusarium species.
Authors: Enrique Chacon-Cruz; Francisco Male-Valle; Rosa M Rivas-Landeros; Erika Z Lopatynsky-Reyes; Lucila A Almada-Salazar; Chandra M Becka Journal: Ther Adv Infect Dis Date: 2018-11-12