amphotericin-b and Lacerations

Topics: Accidental Falls; Accidents, Traffic; Aged, 80 and over; Amphotericin B; Amputation, Surgical; Antifungal Agents; Combined Modality Therapy; Debridement; Fatal Outcome; Female; Fractures, Bone; Fractures, Open; Fungemia; Humans; Humeral Fractures; Immunocompetence; Lacerations; Middle Aged; Mucormycosis; Multiple Trauma; Opportunistic Infections; Postoperative Complications; Recovery Room; Splenectomy; Splenic Rupture; Thigh; Transfusion Reaction; Wound Infection

To report the first case of fungal keratitis caused by presumed Carpoligna species.. A 37-year-old gardener sustained a full-thickness, stellate corneal laceration while cutting wood outdoors with a circular saw. Two months after surgical repair, he developed a severe infectious keratitis with descemetocoele at the apex of the original stellate laceration.. Culture results confirmed fungal elements without evidence of bacteria. Oral and topical voriconazole were initiated. Due to compliance and cost issues, voriconazole was replaced with natamycin 5% prior to discharge from hospital. The patient improved and healed without perforation. The patient was left with a central stromal scar. DNA extraction from the fungal colony allowed PCR amplification of the 28s ribosomal RNA region of the fungus that led to the diagnosis of Carpoligna pleurothecii. Corticosteroids were never used during the patient's treatment.. This is the first reported case of infectious keratitis caused by presumed Carpoligna species. The treatment for Carpoligna pleurothecii keratitis includes voriconazole, natamycin, and possibly amphotericin B.

Topics: Adult; Amphotericin B; Antifungal Agents; Base Sequence; Corneal Injuries; Corneal Ulcer; DNA, Fungal; Eye Infections, Fungal; Eye Injuries; Humans; Lacerations; Male; Mitosporic Fungi; Molecular Sequence Data; Natamycin; Polymerase Chain Reaction; Pyrimidines; RNA, Fungal; RNA, Ribosomal, 28S; Triazoles; Voriconazole