Aspergillus fumigatus keratitis following intracorneal ring segment implantation. 2012

Wisam A Shihadeh
Department of ophthalmology, Faculty of medicine, Jordan University of Science & Technology, Irbid, Jordan. wisam97@yahoo.com

BACKGROUND Fungal keratitis has been rarely reported following intracorneal ring segment (ICRS) inmplantation. This paper aims to report a case of fungal keratitis with aspergillus fumigatus following ICRS implantation for correction of keratoconus. METHODS A retrospective chart review was done. Data including demographics, clinical history and presentation, microbiological analysis as well as clinical management were recorded. RESULTS A 34 year old male presented with pain, photophobia, redness and decreased vision in his right eye ten days after ICRS implantation for correction of keratoconus. Slit-lamp examination showed chemosis, ciliary injection, corneal abcess with ill defined edges and hypopyon. Microbiological analysis and culture of the corneal scrapes were positive for aspergillus fumigatus. The patient did not respond to medical treatment and ended up with corneal transplantation. CONCLUSIONS Although rare, fungal keratitis is a serious vision threatening complication that can complicate intrastromal ring implantation. Prompt and aggressive treatment is essential to prevent irreversible reduction of vision.

UI MeSH Term Description Entries
D007634 Keratitis Inflammation of the cornea. Keratitides
D008297 Male Males
D003319 Corneal Stroma The lamellated connective tissue constituting the thickest layer of the cornea between the Bowman and Descemet membranes. Corneal Stromas,Stroma, Corneal,Stromas, Corneal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000935 Antifungal Agents Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from FUNGICIDES, INDUSTRIAL because they defend against fungi present in human or animal tissues. Anti-Fungal Agents,Antifungal Agent,Fungicides, Therapeutic,Antibiotics, Antifungal,Therapeutic Fungicides,Agent, Antifungal,Anti Fungal Agents,Antifungal Antibiotics
D001232 Aspergillus fumigatus A species of imperfect fungi from which the antibiotic fumigatin is obtained. Its spores may cause respiratory infection in birds and mammals. Aspergillus fumigates,Neosartorya fumigata,Sartorya fumigata
D015821 Eye Infections, Fungal Infection by a variety of fungi, usually through four possible mechanisms: superficial infection producing conjunctivitis, keratitis, or lacrimal obstruction; extension of infection from neighboring structures - skin, paranasal sinuses, nasopharynx; direct introduction during surgery or accidental penetrating trauma; or via the blood or lymphatic routes in patients with underlying mycoses. Mycosis, Ocular,Mycotic Infections, Ocular,Ocular Infections, Fungal,Oculomycosis,Fungal Eye Infections,Eye Infection, Fungal,Fungal Eye Infection,Fungal Ocular Infection,Fungal Ocular Infections,Infection, Fungal Eye,Infection, Fungal Ocular,Infection, Ocular Mycotic,Infections, Fungal Eye,Infections, Fungal Ocular,Infections, Ocular Mycotic,Mycoses, Ocular,Mycotic Infection, Ocular,Ocular Infection, Fungal,Ocular Mycoses,Ocular Mycosis,Ocular Mycotic Infection,Ocular Mycotic Infections,Oculomycoses
D016459 Prosthesis-Related Infections Infections resulting from the implantation of prosthetic devices. The infections may be acquired from intraoperative contamination (early) or hematogenously acquired from other sites (late). Prosthesis Related Infection,Prosthesis-Related Infection,Infections, Prosthesis-Related,Infection, Prosthesis Related,Prosthesis Related Infections,Related Infection, Prosthesis,Related Infections, Prosthesis
D019736 Prostheses and Implants Artificial substitutes for body parts, and materials inserted into tissue for functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the body, tend to be used therapeutically. IMPLANTS, EXPERIMENTAL is available for those used experimentally. Implants, Artificial,Prostheses and Implant,Prosthesis,Prosthetic Implant,Endoprostheses,Endoprosthesis,Prostheses,Prosthetic Implants,Artificial Implant,Artificial Implants,Implant and Prostheses,Implant, Artificial,Implant, Prosthetic,Implants and Prostheses,Implants, Prosthetic

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