RRC ID 46801
著者 Hayashi Y, Eguchi H, Toibana T, Mitamura Y, Yaguchi T.
タイトル Polymicrobial sclerokeratitis caused by Scedosporium apiospermum and Aspergillus cibarius.
ジャーナル Cornea
Abstract PURPOSE:The aim of this study was to report the first case of polymicrobial fungal sclerokeratitis caused by infection with both Scedosporium apiospermum and Aspergillus cibarius, and notify the medical community of the possibility of infection caused by A. cibarius in humans.
METHODS:A 78-year-old woman presented to a medical practitioner with epiphora and a purulent discharge in her left eye. After concurrent administration of topical antibiotics and systemic steroids, her symptoms worsened, and she was referred to the Tokushima University Hospital. Because of suspected fungal infection, microscopic examination and cultivation of both corneal and scleral scrapings were performed.
RESULTS:Fungi were observed on microscopic examination, and S. apiospermum was isolated only from the sclera in the early stage of the clinical course. Although administration of an adequate medication regimen comprising topical and systemic antifungal drugs resulted in an improvement in the sclera, keratitis persisted, and the infected sclera was melted. After scleral transplantation, administration of systemic caspofungin and high concentrations of voriconazole solution eye drops resulted in a gradual improvement in keratitis. A strain of filamentous fungus was isolated from the cornea 6 weeks after the cultivation on a Sabouraud agar plate, and it was identified as A. cibarius.
CONCLUSIONS:A. cibarius may infect human tissue. Coinfection of the cornea and the sclera with 2 different species of fungi is likely to follow a complex clinical course.
巻・号 33(8)
ページ 875-7
公開日 2014-8-1
DOI 10.1097/ICO.0000000000000172
PMID 24937168
MeSH Aged Antifungal Agents / therapeutic use Aspergillus / isolation & purification* Caspofungin Coinfection / diagnosis Coinfection / drug therapy Coinfection / microbiology* Drug Therapy, Combination Echinocandins / therapeutic use Eye Infections, Fungal / diagnosis Eye Infections, Fungal / drug therapy Eye Infections, Fungal / microbiology* Female Humans Keratitis / diagnosis Keratitis / drug therapy Keratitis / microbiology* Lipopeptides Scedosporium / isolation & purification* Scleritis / diagnosis Scleritis / drug therapy Scleritis / microbiology* Voriconazole / therapeutic use
IF 2.215
引用数 6
WOS 分野 OPHTHALMOLOGY
リソース情報
病原微生物 NA