Scedosporium apiospermum keratitis treated with itraconazole.
Mycotic keratitis usually occurs in conjunction with trauma to the cornea. Scedosporium apiospermum, a dematiaceous fungus linked to the teleomorph Pseudallescheria boydii is not a common agent of mycotic keratitis. A 22-year old male patient with mycotic keratitis due to S. apiospermum is presented. In in vitro susceptibility testing, the isolate showed resistance against amphotericin B (minimum inhibitory concentration [MIC] 16 microg ml(-1)) but was susceptible to itraconazole (ITC) and fluconazole with MICs of 0.125 microg ml(-1) and 4 microg ml(-1), respectively. The patient was cured clinically after ITC treatment and surgical intervention. Azoles may be superior for eliminating S. apiospermum from infected ocular sites.
Saracli
M A
MA
Division of Medical Mycology, Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine, 06018 Etlik Ankara, Turkey. masaracli@gata.edu.tr
Erdem
U
U
Gonlum
A
A
Yildiran
S T
ST
D000328:Adult; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D025141:Drug Resistance, Fungal; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology / Q000627:therapeutic use*; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008271:Mycetoma / Q000188:drug therapy* / Q000382:microbiology; D021681:Scedosporium / Q000187:drug effects* / Q000302:isolation & purification; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole