title: Therapeutic contact lens-related bilateral fungal keratitis.
abstract: OBJECTIVE
  To describe a rare case of bilateral Candida keratitis after contact lens use following bilateral penetrating keratoplasty (PK).
  
  
  METHODS
  A 40-year-old female with a clinical diagnosis of Sjögren's syndrome was being followed for corneal thinning in both eyes. She suffered a spontaneous bilateral perforation and underwent penetrating keratoplasty. Therapeutic contact lenses were prescribed for both eyes owing to persistent epithelial defects. Two months later, a biomicroscopic examination revealed corneal infiltrates.
  
  
  RESULTS
  A corneal tissue sample, saline, and contact lens cultures were all positive for Candida albicans. Topical and systemic antifungal therapy successfully cleared the infection in the right eye; however, the left eye underwent another corneal graft surgery.
  
  
  CONCLUSIONS
  Infectious fungal keratitis may be a complication of wearing therapeutic contact lenses after PK, in a patient with Sjögren's syndrome. The pre-existing eye disease is an important associated factor in cases of yeast infection; therefore, adequate care of these patients and careful follow-up after PK are indicated as measures to prevent early infections.
authors.affiliation: Ophthalmology Department, Federal University of São Paulo, Brasil.
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Höflin-Lima
authors.forename: Roberto
authors.initials: R
authors.lastname: Roizenblatt
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000209:etiology / Q000628:therapy; D003261:Contact Lenses / Q000009:adverse effects*; D015821:Eye Infections, Fungal / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000628:therapy; D015948:Keratoplasty, Penetrating; D009883:Ophthalmic Solutions; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions