A case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton species.

Abstract:

BACKGROUND:Fungal keratitis is difficult to treat that can result in corneal blindness requiring penetrating keratoplasty and in fungal endothalmitis. We report a case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton. CASE PRESENTATION:A 77-year old male presented with ocular pain, conjunctival injection, and severe loss of vision in his left eye. His best corrected visual acuity was hand movements in the left eye, and slit-lamp examination showed a corneal ulcer with feathery margin and hypopyon. Bacterial and fungal smear/culture showed no organism, and there was no improvement in spite of treatment with topical fortified 5% cefazolin and 2% tobramycin. Trichophyton species was identified by repeated cultures. We found onychomycosis on the patient's foot, where the same fungal species were identified. Regimen was changed to topical itraconazole and systemic intravenous itraconazole. No clinical improvement was observed, so therapeutic penetrating keratoplasty and cryotherapy was done with continuation of antifungal therapy. The graft was clear at postoperative 1 month and no evidence of recurrence was found. CONCLUSION:It is important to identify the pathogen of keratitis because early identification of pathogen causing keratitis provides the appropriate treatment in early phase of keratitis. It is necessary to search for other fungal skin infections such as onychomycosis and athelete's foot considering the fungal keratitis following skin infection. In addition, fungal skin infection including onychomycosis should be treated for prevention of fungal keratitis as soon as possible.

journal_name

BMC Ophthalmol

journal_title

BMC ophthalmology

authors

Jin KW,Jeon HS,Hyon JY,Wee WR,Suh W,Shin YJ

doi

10.1186/1471-2415-14-90

subject

Has Abstract

pub_date

2014-07-11 00:00:00

pages

90

issn

1471-2415

pii

1471-2415-14-90

journal_volume

14

pub_type

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