Clinical experiences in fungal keratitis caused by Acremonium
A 76-year old man complaining of severe ocular pain in his left eye was referred to our hospital. He had a history of trauma by plant material. Slit-lamp biomicroscopy showed a central corneal infiltrate that was associated with a large epithelial defect and hypopyon (). The patient was started on an hourly instillation of topical 0.5% moxifloxacin, and intravenous ciprofloxacin, twice daily. After 5 days on this therapy, the condition of the left eye worsened with the appearance of an endothelial plaque. Repeated corneal smears showed septate fungal hyphae. The patient was administered with hourly doses of 0.15% amphotericin B and 0.2% fluconazole, with oral fluconazole. Over the next 7 days, corneal cultures were positive for Acremonium. Topical 5% natamycin and 1% voriconazole (Vfend; Pfizer Pharmaceuticals Korea, Seoul, Korea) with oral fluconazole were prescribed immediately. The final VA was 0.5, and there was no recurrence in the following 6 months ().