[Fungal keratitis--diagnostic and therapeutic approach]

Abstract

Introduction: Fungal keratitis is one of the most difficult corneal infections to be properly diagnosed and treated.

Purpose: Diagnostic and therapeutic approaches in atypical keratitis, regarding a case.

Material and method: The paper presents a case of stromal fungal keratitis successfully treated with topical amphotericin B 0,2% and natamycin 5%. The clinical appearance and the indolent course directed the diagnosis, the micro-biological analysis of corneal scrapings being negative. Further on, there are presented the laboratory investigations and the available antifungal agents, because proper therapy early in the course of the disease can be crucial to a successful outcome.

Conclusions: Clinical suspicion of fungal keratitis is essential to diagnosis, but once the diagnosis is made, the treatment remains difficult. Direct microscopic examination of corneal tissues using specific stains is a very useful and inexpensive method of diagnosis, being conclusive in 80% of cases.