The article presents a clinical case of fungal keratitis in corneal transplant. A patient 4 months after penetrating keratoplasty performed for progressive corneal ulcer, was diagnosed with recurrence of fungal keratitis. Repetitive penetrating keratoplasty and subsequent anti-inflammatory therapy were performed, but 3 months later white infiltrate with distinct borders appeared in the center of corneal transplant that required removal. Laboratory investigation of the removed fragment revealed Fusarium mycelium; antimycotic treatment with amphotericin B 0.2% topically and intraconazole orally was administered for 3 weeks. In a month after the treatment visual function remained equal to correct light perception, corneal transplant was totally opacified without edema, and corneal defects re-epithelialized. Ophthalmologic examination in 2-3 months showed absence of ocular pain, smooth corneal surface without epithelial defects and corneal transplant opacity. Laboratory diagnostics is necessary in case of fungal infection suspicion. During penetrating keratoplasty for fungal corneal disease, corneal infiltrate has to be removed within intact corneal tissue. Fungal corneal infection recurrence in corneal transplant occurs at the donor-recipient interface.
[1]
M. Srinivasan,et al.
Effect of pretreatment with antifungal agents on clinical outcomes in fungal keratitis
,
2016,
Clinical & experimental ophthalmology.
[2]
Q. Le,et al.
Early-Onset Candida glabrata Interface Keratitis after Deep Anterior Lamellar Keratoplasty
,
2015,
Optometry and vision science : official publication of the American Academy of Optometry.
[3]
J. Tsai,et al.
Early-onset severe donor-related Candida keratitis after descemet stripping automated endothelial keratoplasty.
,
2014,
Journal of the Formosan Medical Association = Taiwan yi zhi.
[4]
A. Villarrubia,et al.
Candida Keratitis after Descemet Stripping with Automated Endothelial Keratoplasty
,
2014,
European journal of ophthalmology.
[5]
M. Carrasco,et al.
Treatment of Severe Fungal Keratitis With Subconjunctival Amphotericin B
,
2011,
Cornea.
[6]
R. Feder,et al.
Fungal Keratitis With Intracameral Extension Following Penetrating Keratoplasty
,
2009,
Cornea.
[7]
R. Feder.
Diagnosis and treatment of fungal keratitis
,
1990
.