Voriconazole in Fungal Keratitis Caused by Scedosporium apiospermum

OBJECTIVE To describe the first case, to the best of our knowledge, of posttraumatic Scedosporium apiospermum (ScA) keratitis successfully treated with systemic and topical voriconazole. CASE SUMMARY A 19-year-old man was admitted to the hospital with an incisive wound of his left eye and the cornea...

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Published in:The Annals of pharmacotherapy 2004-03, Vol.38 (3), p.414-417
Main Authors: Prats, Carmen Hernandez, Tello, Francisca Llinares, Jose, Amparo Burgos San, Otaolaurruchi, Juan Selva, Baines, Juan Pablo Ordovas
Format: Article
Language:English
Subjects:
Adult
Antifungal Agents - therapeutic use
Eye Injuries - microbiology
Humans
Keratitis - drug therapy
Keratitis - etiology
Male
Pyrimidines - therapeutic use
Scedosporium
Triazoles - therapeutic use
Voriconazole
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Summary:OBJECTIVE To describe the first case, to the best of our knowledge, of posttraumatic Scedosporium apiospermum (ScA) keratitis successfully treated with systemic and topical voriconazole. CASE SUMMARY A 19-year-old man was admitted to the hospital with an incisive wound of his left eye and the cornea totally sectioned after trauma with a cutter used in gardening. Initial empirical treatment was followed by systemic and topical voriconazole, and the eye did not have to be enucleated. Five months after the trauma, a penetrating keratoplasty and chamber intraocular lens implantation was performed with a favorable visual outcome. DISCUSSION ScA keratitis is rare, but it must be suspected if a history of ocular injury with contaminated objects exists. Among the antifungals available to treat ScA keratitis, voriconazole has shown advantages such as the lowest minimum inhibitory concentration and the availability of an oral formulation. CONCLUSION Voriconazole shows promise as an effective alternative to conventional antifungals in the treatment of ScA keratitis. It is available both as oral and intravenous preparations, which is a great advantage in these lengthy infections.
ISSN:1060-0280
1542-6270
DOI:10.1345/aph.1D128