Fungal scleritis after cataract surgery. Successful outcome using itraconazole.
We report the development of fungal scleritis in a 53-year-old man after uncomplicated cataract surgery. Histopathology and culture identified the organism as Aspergillus flavus. Clinically, the patient worsened on treatment with oral ketoconazole and topical amphotericin B with progression of multifocal scleral nodules and necrosis. Resolution of inflammation was achieved using oral itraconazole, a new triazole antifungal agent. The patient achieved 20/15-2 visual acuity and remains free of symptoms and signs for greater than 2 years after discontinuation of all treatment.
Carlson
A N
AN
Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina 27710.
Foulks
G N
GN
Perfect
J R
JR
Kim
J H
JH
D000284:Administration, Oral; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology; D001231:Aspergillus flavus; D002387:Cataract Extraction / Q000009:adverse effects*; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D017964:Itraconazole; D007654:Ketoconazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015423:Scleritis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D016896:Treatment Outcome; D014792:Visual Acuity
D000935:Antifungal Agents; D017964:Itraconazole; D007654:Ketoconazole