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. 2016 Dec 7:5:81-84.
doi: 10.1016/j.ajoc.2016.12.005. eCollection 2017 Apr.

A rare case of Phialemonium obovatum keratitis

Emma C Davies  1   2 , Mary K Daly  1   3   2 , Donna Siracuse-Lee  1   3
Affiliations

A rare case of Phialemonium obovatum keratitis

Emma C Davies et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: We report a rare case of Phialemonium obovatum fungal keratitis in a patient sustaining a corneal laceration from impact with a piece of moldy plaster.

Observations: The patient was treated with topical voriconazole with resolution of active keratitis and formation of a stromal scar. The patient's final visual acuity was 20/20 in the affected eye.

Conclusions and importance: There is only one other case of Phialemonium obovatum keratitis reported in the literature. The patient in the previous case required amniotic membrane transplantation for persistent stromal melting with resultant visual acuity of hand motions only. The present case demonstrates that the early use of topical antifungal medication with close follow-up can prevent corneal perforation and result in excellent visual acuity.

Keywords: Corneal ulcer; Fungal keratitis; Phialemonium obovatum.

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Figures

Fig. 1
Fig. 1
Slit lamp photograph of the right eye demonstrating a feathery stromal infiltrate along the inferior margin of the epithelial defect located paracentrally at 3 o'clock. Slit lamp beam illuminating epithelial defect and portion of the infiltrate.
Fig. 2
Fig. 2
Anterior segment optical coherence tomography of the right eye showing irregular and missing epithelium over region with underlying stromal hyperintensity suggestive of an infiltrate.
Fig. 3
Fig. 3
Slit lamp photograph of the right eye demonstrating five punctate stromal infiltrates and epithelial irregularity highlighted by the slit lamp beam.
Fig. 4
Fig. 4
Confocal microscopy of the right eye with branching hyphae within corneal stroma at the site of the corneal infiltrate at 245 μm.
See this image and copyright information in PMC

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