J Korean Ophthalmol Soc > Volume 57(3); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(3):390-398.
DOI: https://doi.org/10.3341/jkos.2016.57.3.390    Published online March 15, 2016.
Paecilomyces Keratitis: Cases in Korea and Literature Review.
Sae Rom Chung, In Cheon You, Nam Chun Cho, Min Ahn
1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. you2ic@daum.net
2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
패실로마이세스 각막염: 국내 증례 보고 및 해외 문헌 고찰
정새롬1⋅유인천1,2,3⋅조남천1,2,3⋅안 민1,2,3
전북대학교 의학전문대학원 안과학교실1, 전북대학교 임상의학연구소2, 전북대학교병원 의생명연구원3
Abstract
PURPOSE
To analyze the Paecilomyces keratitis cases in Korea and compare cases from foreign literature. METHODS: The records of 3 patients diagnosed with Paecilomyces keratitis at our hospital and other reported cases in Korea were evaluated to examine the predisposing factors, clinical aspects, antifungal therapy, therapeutic surgery, and visual outcome and compared with previously reported foreign cases. RESULTS: In Korea, 1 patient was female, 4 patients were male and had predisposing factors including prior corneal trauma or surgery, except 1 spontaneous occurrence. All 5 eyes of 5 patients had poor initial visual acuity, less than finger count, and deep corneal infiltration. The patients were treated with multiple topical and systemic antifungal treatments such as intracameral or intrastromal voriconazole injections and required evisceration and penetrating keratoplasty. However, the final outcomes were unsatisfactory. Previously reported cases from foreign literature also had predisposing factors such as corneal surgery, trauma, and soft contact lens use. They were resistant to antifungal therapy and eventually led to surgeries such as penetrating keratoplasty and the final outcomes were poor. CONCLUSIONS: Frequently, Paecilomyces keratitis has direct risk factors and is resistant to many topical and systemic antifungal agents. In the majority of cases, therapeutic surgery was required and the final visual outcomes were poor. When Paecilomyces keratitis is suspected, we suggest aggressive therapy including intracameral and intravitreal injections of voriconazole in the initial treatment.
Key Words: Corneal ulcer;Fungal keratitis;Paecilomyces;Voriconazole


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