Trichophyton fungal keratitis.
OBJECTIVE
To report 5 cases of fungal keratitis caused by Trichophyton schoenleinii.


METHODS
Case reports.


RESULTS
Trichophyton schoenleinii is responsible for aggressive fungal keratitis that is associated with keratolysis as a result of collagenase expression by the organism. Clinically, the organism seems to be sensitive to topical natamycin but resistant to topical amphotericin B and miconazole. Two patients achieved clinical cures with medical therapy alone, but with visual outcomes of only 20/125 and hand motions because of corneal scarring. Two patients achieved clinical cures with therapeutic penetrating keratoplasty (PKP), which remained clear and provided final visual outcomes of 20/60 and 20/200. One patient developed fungal scleritis and panophthalmitis despite 2 therapeutic PKPs and required enucleation.


CONCLUSIONS
Trichophyton schoenleinii is a rare cause of fungal keratitis that may be associated with progressive keratolysis and perforation, scleral extension, and endophthalmitis. Therapeutic keratoplasty may be successful in achieving cure in medically unresponsive cases.
Mohammad
Abdulkarim
A
Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
Al-Rajhi
Abdulaziz
A
Wagoner
Michael D
MD
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014005:Tinea / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014249:Trichophyton / Q000302:isolation & purification*
D000890:Anti-Infective Agents