title: Successful Treatment ofLasiodiplodia theobromaeKeratitis - Assessing the Role of Voriconazole.
abstract: OBJECTIVE
  The aim of this paper is to report the successful management of the first case ofLasiodiplodia theobromaekeratitis in Hong Kong.
  
  
  METHODS
  We conducted a case report.
  
  
  RESULTS
  A 43-year-old Chinese male with a history of diabetes developed left eye keratitis after a trauma during tree felling. Fungal keratitis was diagnosed using a confocal microscope on day 1, andL. theobromaewas confirmed from the culture. He was given oral voriconazole, topical natamycin, and topical and intracameral amphotericin B. The patient's condition improved after the initial treatment. However, there was a slow progression to descemetocele formation and impending perforation due to corneal melting. Penetrating keratoplasty was performed at 8 weeks after presentation. Final visual recovery was good with no recurrence of infection. The cornea remained clear.
  
  
  CONCLUSIONS
  We report the first case ofL. theobromaekeratitis in Hong Kong, and it is the only case so far that involved the use of oral voriconazole in the combination therapy. Early recognition with the aid of confocal microscopy allowed the early start of treatment. The use of newer antifungal voriconazole topically and orally combined with topical amphotericin B appeared to be useful in the eradication of the fungus and prevention of recurrence. Intracameral antifungals might have improved the clinical management.
authors.affiliation: Tuen Mun Eye Centre, Tuen Mun, Hong Kong SAR.
authors.forename: Stephen Tak-Lun
authors.initials: ST
authors.lastname: Li
authors.affiliation: Tuen Mun Eye Centre, Tuen Mun, Hong Kong SAR.
authors.forename: Evan Po-Fat
authors.initials: EP
authors.lastname: Yiu
authors.affiliation: Tuen Mun Eye Centre, Tuen Mun, Hong Kong SAR.
authors.forename: Angela Hiu-Yan
authors.initials: AH
authors.lastname: Wong
authors.affiliation: Tuen Mun Eye Centre, Tuen Mun, Hong Kong SAR.
authors.forename: John Chun-Ting
authors.initials: JC
authors.lastname: Yeung
authors.affiliation: Tuen Mun Eye Centre, Tuen Mun, Hong Kong SAR.
authors.forename: Lester Wang-Hon
authors.initials: LW
authors.lastname: Yu
keywords: Fungus; Keratitis; Lasiodiplodia theobromae; Voriconazole