Mycotic Keratitis Caused by Fusarium solani sensu stricto (FSSC5): A Case Series

Mycopathologia. 2018 Oct;183(5):835-840. doi: 10.1007/s11046-018-0280-7. Epub 2018 Jun 21.

Abstract

Owing to a lack of appropriate diagnostic and therapeutic approaches for mycotic keratitis, approximately one million cases of preventable corneal blindness are reported each year. The number of keratitis cases due to infection with Fusarium is increasing significantly worldwide, many of which are not treated adequately and in a timely manner due to frequent misdiagnosis. In the current report, we describe three cases of keratitis caused by Fusarium solani sensu stricto (FSSC5) from Turkey and The Netherlands, following ocular trauma. The etiological agent of keratitis, FSSC5, identified by sequencing of the partial tef1-α gene, exhibited low minimum inhibitory concentrations (MICs) of 1 µg/mL for amphotericin B and high MICs above the published epidemiological cutoff values for voriconazole (8 µg/mL). Patients were successfully treated with topical amphotericin B and voriconazole with complete recovery.

Keywords: Amphotericin B; Chlorhexidine gluconate; Keratomycosis; Soft contact lenses; Voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Amphotericin B / administration & dosage
  • Amphotericin B / pharmacology
  • Antifungal Agents / pharmacology
  • Eye Infections, Fungal / diagnosis*
  • Eye Infections, Fungal / microbiology
  • Eye Infections, Fungal / pathology*
  • Eye Injuries / complications
  • Female
  • Fungal Proteins / genetics
  • Fusariosis / diagnosis*
  • Fusariosis / microbiology
  • Fusariosis / pathology*
  • Fusarium / classification
  • Fusarium / drug effects
  • Fusarium / genetics
  • Fusarium / isolation & purification*
  • Humans
  • Keratitis / etiology*
  • Keratitis / microbiology
  • Keratitis / pathology*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Netherlands
  • Peptide Elongation Factor 1 / genetics
  • Sequence Analysis, DNA
  • Treatment Outcome
  • Turkey
  • Voriconazole / administration & dosage
  • Voriconazole / pharmacology

Substances

  • Antifungal Agents
  • Fungal Proteins
  • Peptide Elongation Factor 1
  • Amphotericin B
  • Voriconazole