Insurgence of Fusarium keratitis associated with contact lens wear.
OBJECTIVE
To describe the clinical presentation and course of patients who developed keratitis due to Fusarium while wearing nontherapeutic soft contact lenses.


METHODS
A retrospective review of microbiologic records from January 1, 2004, through April 15, 2006, was performed, identifying all patients with corneal ulceration and a culture positive for Fusarium species. Medical records of 34 patients were reviewed for clinical characteristics, treatment regimens, and microbiologic features.


RESULTS
The most common antimicrobial medications administered prior to Fusarium diagnosis were antibacterials in 31 of 34 patients. No distinct preponderance of any one brand of either contact lens or solution was identified. The microbiologic corneal cultures found Fusarium oxysporum in 20 cases, Fusarium solani in 3 cases, Fusarium species not further identifiable in 10 cases, and no growth in 1 case. Patients with a delayed onset of treatment had a tendency for prolonged treatment until cure.


CONCLUSIONS
Fusarium has previously been an unusual organism in the etiology of infectious keratitis in the setting of nontherapeutic soft contact lens wear. A delay in proper diagnosis and intervention may contribute to a prolonged treatment course. The microbial spectrum of contact lens-related keratitis may be evolving with higher participation of Fusarium species compared with prior reports.
Alfonso
Eduardo C
EC
Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.
Cantu-Dibildox
Jorge
J
Munir
Wuqaas M
WM
Miller
Darlene
D
O'Brien
Terrence P
TP
Karp
Carol L
CL
Yoo
Sonia H
SH
Forster
Richard K
RK
Culbertson
William W
WW
Donaldson
Kendall
K
Rodila
Jill
J
Lee
Yunhee
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D003315:Cornea / Q000382:microbiology; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005670:Fusarium / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies
D000935:Antifungal Agents