PMID: 15220739Jun 29, 2004Paper

Fungal keratitis caused by Paecilomyces lilacinus associated with a retained intracorneal hair

Cornea
Kent L AndersonHugh R Taylor

Abstract

To report a case of fungal keratitis caused by Paecilomyces lilacinus (P. lilacinus) associated with a retained intracorneal hair. A 61-year-old man developed pain, decreased vision, hyperemia, and corneal infiltrates in his right eye without any predisposing factor. An intracorneal hair had migrated superiorly in the corneal stroma, giving rise to 3 separate stromal infiltrates. The patient demonstrated a waxing and waning course over several months despite antimicrobial and steroid therapy. Histopathologic examination of a corneal biopsy specimen disclosed the presence of fungal elements, and intensive antifungal therapy was initiated. Verticillium sp. was initially identified as the causative organism, but after failure to improve on topical natamycin, subsequent investigations demonstrated the pathogen to be P. lilacinus that was resistant to routine antifungal agents. The patient was then initiated on systemic voriconazole and terbinafine. He responded well to treatment and ultimately recovered a best-corrected visual acuity of 6/15 in the affected eye. This is the first case of P. lilacinus keratitis associated with a retained intracorneal hair. Hair in the cornea could be a predisposing factor for this infection. Early c...Continue Reading

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Citations

Aug 20, 2011·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·A-K B MaierP Rieck
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