Subconjunctival Injection of Fluconazole in the Treatment of Fungal Alternaria Keratitis.
OBJECTIVE
We report two cases of Alternaria keratitis refractory to the conventional antifungal medical treatment successfully treated with subconjunctival fluconazole injection.


METHODS
Report of two cases.


RESULTS
After subconjunctival injection of fluconazole (2 mg/mL) 0.5 mL twice a day for 5 days then once a day till 14 days, two cases of Alternaria keratitis refractory to the conventional antifungal medical treatment were successfully treated. No severe local and systemic side effects were found in these two patients.


CONCLUSIONS
Alternaria keratitis has a varied clinical presentation and suspicion must be maintained for unusual causes of infectious keratitis. Alternaria keratitis can be difficult to eradicate even with traditional antifungals such as amphotericin B and natamycin. Subconjunctival injection of fluconazole could be effective for Alternaria keratitis unresponsive to conventional antifungal medical treatment.
a Department of Ophthalmology , E-Da Hospital/I-Shou University , Kaohsiung , Taiwan and.
Shih-Hao
SH
Tsai
a Department of Ophthalmology , E-Da Hospital/I-Shou University , Kaohsiung , Taiwan and.
Yen-Chun
YC
Lin
a Department of Ophthalmology , E-Da Hospital/I-Shou University , Kaohsiung , Taiwan and.
Huan-Chen
HC
Hsu
a Department of Ophthalmology , E-Da Hospital/I-Shou University , Kaohsiung , Taiwan and.|b Department of Ophthalmology , National Taiwan University Hospital , Taipei , Taiwan.
Yan-Ming
YM
Chen
D000368:Aged; D000528:Alternaria / Q000302:isolation & purification*; D060487:Alternariosis / Q000188:drug therapy* / Q000382:microbiology; D000935:Antifungal Agents / Q000627:therapeutic use*; D003228:Conjunctiva / Q000187:drug effects; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D025141:Drug Resistance, Fungal; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged
D000935:Antifungal Agents; D015725:Fluconazole