The successful medical treatment of a case of Paecilomyces lilacinus keratitis.
OBJECTIVE
To report the successful medical treatment of Paecilomyces lilacinus keratitis case with topical voriconazole.


METHODS
A 72-year-old male farmer developed a corneal infection in the left eye and corneal culture revealed Paecilomyces lilacinus. Infection was progressive despite initial treatment with hourly topical amphotericin B (1.5 mg/mL) and topical 5% natamycin. Treatment was switched to hourly topical voriconazole (10 mg/mL).


RESULTS
The infection responded well to topical voriconazole and resolved within 1 month without any surgical intervention. The patient's best-corrected visual acuity was 20/200 secondary to central corneal scarring and a cataract in the left eye at the 10-month follow-up.


CONCLUSIONS
Voriconazole may be effective in the treatment of Paecilomyces lilacinus keratitis refractory to standard antifungal agents. Early organism detection and appropriate treatment are necessary to eradicate such an infection.
Wu
Pei-Chen
PC
Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China.
Lai
Chien-Hsiung
CH
Tan
Hsin-Yuan
HY
Ma
David H K
DH
Hsiao
Ching-Hsi
CH
D000287:Administration, Topical; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D010143:Paecilomyces / Q000302:isolation & purification*; D011743:Pyrimidines / Q000627:therapeutic use*; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole