title: Combination of intracameral and intrastromal voriconazole in the treatment of recalcitrant Acremonium fungal keratitis.
abstract: We present a report of a 28-year-old female with fungal keratitis due to Acremonium that was unresponsive to full medical therapy over 3 weeks. The patient was treated with superficial keratectomy, intrastromal and intracameral voriconazole injections. There was a marked clinical improvement beginning on day 3 post-therapy that was sustained until the last follow-up at 6 months. This is the first case of fungal keratitis due to Acremonium treated by a combination of intrastromal and intracameral voriconazole. This cost-effective treatment modality proved to be significant in impeding the progression of this potentially blinding disease and improving visual prognosis.
authors.affiliation: Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
authors.forename: Randa S
authors.initials: RS
authors.lastname: Haddad
authors.forename: Georges M
authors.initials: GM
authors.lastname: El-Mollayess
mesh_terms: D000164:Acremonium / Q000302:isolation & purification*; D000328:Adult; D000867:Anterior Chamber; D000935:Antifungal Agents / Q000008:administration & dosage; D003319:Corneal Stroma / Q000382:microbiology; D003937:Diagnosis, Differential; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000008:administration & dosage*; D014230:Triazoles / Q000008:administration & dosage*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole