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Case Reports
. 2019 Apr 24;12(4):e229226.
doi: 10.1136/bcr-2019-229226.

Recalcitrant Paecilomyces keratitis

Seetha Lakshmi  1 , Cristina Vanessa Garcia  1
Affiliations
Case Reports

Recalcitrant Paecilomyces keratitis

Seetha Lakshmi et al. BMJ Case Rep. .

Abstract

A 54-year-old Caucasian woman presented with corneal ulcer of the right eye of 4 weeks duration after scratching her cornea while removing her contact lens and artificial eye lashes. Her visual acuity was 20/32 (left eye) and finger counting (right eye). She had a 3x3 mm epithelial defect with underlying corneal oedema and hypopyon. Right eye cultures grew Paecilomyces species. Topical and systemic antifungal agents were initiated. Due to the sight-threatening disease, the patient underwent surgical intervention with intrastromal injection of amphotericin B and a large conjunctival flap covering 75% of the right eye corneal ulcer. After 3 months of therapy, she had near-complete resolution of the corneal ulcer. Unfortunately, recurrence of the corneal ulcer occurred within 3 weeks of cessation of therapy, prompting reinitiation of ophthalmic and systemic antifungal agents. The patient was advised to continue therapy for 6 months with regular follow-up.

Keywords: infectious diseases; ophthalmology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Paecilomyces species appear as powdery olive colonies on Sabarouds dextrose agar.
Figure 2
Figure 2
Paecilomyces species conidiophores demonstrated by lactophenol cotton blue stain on a ×40 objective lens.
Figure 3
Figure 3
Anterior chamber of the right eye with hypopyon and an epithelial defect that measured 4.5x4.0 mm infiltrate with 1.5x3.0 mm.
See this image and copyright information in PMC

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