Beauveria keratitis and biopesticides: case histories and a random amplification of polymorphic DNA comparison.
OBJECTIVE
The purposes of this study were to describe 2 contact lens-associated Beauveria keratitis cases and to compare the isolates of 3 contact lens-associated Beauveria keratitis cases with Beauveria-based biopesticides using random amplification of polymorphic DNA (RAPD).


METHODS
A 55-year-old diabetic woman from New Mexico and a 31-year-old healthy woman from southern Wisconsin developed soft contact lens-related corneal ulcers unresponsive to topical moxifloxacin and prednisolone acetate drops. Their corneal cultures grew B. bassiana. These isolates, an isolate from a third soft contact lens-related Beauveria keratitis case, and Beauveria-based biopesticides sold in the United States were analyzed using morphological features, DNA sequencing, and RAPD. A PubMed, Cochrane Library, OVID, UpToDate, and Google search using the term "Beauveria" found only 9 reported Beauveria keratitis infections.


RESULTS
Patient 1 responded to topical natamycin, ketoconazole, and 200 mg oral ketoconazole twice daily before developing a secondary bacterial infection requiring penetrating keratoplasty. After subsequent cataract surgery, the best-corrected visual acuity was 20/20. Patient 2 was treated with topical natamycin, topical amphotericin, and 200 mg oral voriconazole twice daily for 1 month with residual scarring and a best-corrected visual acuity of 20/25. RAPD showed that all isolates were unrelated.


CONCLUSIONS
Although earlier reported Beauveria keratitis cases occurred after corneal injury in patients who did not wear contact lenses, 3 recent patients wore soft contact lenses and denied trauma, mirroring a changing trend in microbial keratitis. RAPD analysis showed that the Beauveria isolates were unrelated to one another and to Beauveria-based biopesticides. In Patient 2, oral voriconazole worked well.
Pariseau
Brett
B
Department of Ophthalmology, Monroe Clinic, Monroe, WI, USA.
Nehls
Sarah
S
Ogawa
Gregory S H
GS
Sutton
Deanna A
DA
Wickes
Brian L
BL
Romanelli
Anna M
AM
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D052982:Beauveria / Q000235:genetics / Q000302:isolation & purification*; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004271:DNA, Fungal / Q000032:analysis; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010571:Pest Control; D011743:Pyrimidines / Q000627:therapeutic use; D019105:Random Amplified Polymorphic DNA Technique; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D004271:DNA, Fungal; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole