title: [Fungal keratitis caused by Cylindrocarpon lichenicola].
abstract: We report a case of a 67-year-old woman with no significant past ocular history, who was referred for management of an unresponsive microbial keratitis resulting from trauma with a piece of clothing fabric 1 month previously in Portugal and worsening despite topical fortified antibiotics. On examination, visual acuity was limited to "light perception". Slit lamp examination revealed an 11×11mm full-thickness corneal infiltrate. Confocal images showed branching hyphae suggestive of a fungal infection. Fungal cultures of corneal scrapings revealed growth of Cylindrocarpon lichenicola, a saprophytic, filamentous fungus, which is an unusual cause of keratitis. Despite aggressive antifungal therapy with voriconazole and amphotericin B, she required penetrating keratoplasty for impending corneal perforation. Follow-up was uneventful, with no recurrence at 1 year. Fungal infections must be suspected in all corneal ulcers of traumatic etiology. Specific cultures and confocal microscopy must be performed early, so as to enable early treatment modification.
authors.affiliation: Service d'ophtalmologie 5, Pr-Laroche, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75571 Paris, France. thomasgaujoux@yahoo.fr
authors.forename: T
authors.initials: T
authors.lastname: Gaujoux
authors.forename: E
authors.initials: E
authors.lastname: Borsali
authors.forename: J-C
authors.initials: JC
authors.lastname: Gavrilov
authors.forename: O
authors.initials: O
authors.lastname: Touzeau
authors.forename: P
authors.initials: P
authors.lastname: Goldschmidt
authors.forename: M-C
authors.initials: MC
authors.lastname: Despiau
authors.forename: C
authors.initials: C
authors.lastname: Chaumeil
authors.forename: L
authors.initials: L
authors.lastname: Laroche
authors.forename: V
authors.initials: V
authors.lastname: Borderie
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D015821:Eye Infections, Fungal / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000628:therapy; D015948:Keratoplasty, Penetrating
chemical_list: D000935:Antifungal Agents