title: Fusarium dimerum Species Complex (Fusarium penzigii) Keratitis After Corneal Trauma.
abstract: We report a case of a keratitis associated with a Fusarium penzigii-a Fusarium dimerum species complex (FDSC)-in a 81-year-old woman after a corneal trauma with a tree branch. At patient admittance, slit lamp biomicroscopy revealed an exuberant chemosis, an inferior corneal ulcer with an associated inflammatory infiltrate, a central corneal abscess, bullous keratopathy and posterior synechiae. Corneal scrapes were obtained for identification of bacteria and fungi, and the patient started antibiotic treatment on empirical basis. Few days later, the situation worsened with the development of hypopyon. By that time, Fusarium was identified in cultures obtained from corneal scrapes and the patient started topical amphotericin B 0.15 %. Upon the morphological identification of the Fusarium as a FDSC, and since there was no clinical improvement, the treatment with amphotericin B was suspended and the patient started voriconazole 10 mg/ml, eye drops, hourly and voriconazole 200 mg iv, every 12 h for 1 month. The hypopyon resolved and the inflammatory infiltrate improved, but the abscess persisted at the last follow-up visit. The molecular identification revealed that the FDSC was a F. penzigii.
authors.affiliation: Serviço de Patologia Clinica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Anália
authors.initials: A
authors.lastname: do Carmo
authors.affiliation: Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Costa
authors.affiliation: Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Marco
authors.initials: M
authors.lastname: Marques
authors.affiliation: Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Quadrado
authors.affiliation: Serviço de Patologia Clinica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. rtome@huc.min-saude.pt.
authors.forename: Rui
authors.identifier: http://orcid.org/0000-0001-5381-2705
authors.initials: R
authors.lastname: Tomé
mesh_terms: D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage; D065306:Corneal Injuries / Q000150:complications*; D005260:Female; D060585:Fusariosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D005670:Fusarium / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D007634:Keratitis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D016896:Treatment Outcome; D065819:Voriconazole / Q000008:administration & dosage
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D065819:Voriconazole
keywords: Amphotericin B; Fusarium dimerum; Fusarium dimerum species complex; Fusarium penzigii; Keratitis; Voriconazole