Höfling-Lima Ana Luisa, Guarro Josep, Freitas Denise de, Godoy Patricio, Gené Josepa, Souza Luciene Barbosa de, Zaror Luis, Romano Andre C
Departamento de Oftalmologia, Universidade Federal de São Paulo, São Paulo, SP.
Arq Bras Oftalmol. 2005 Mar-Apr;68(2):270-2. doi: 10.1590/s0004-27492005000200023. Epub 2005 May 18.
To report an unusual case of fungus keratitis due to Fonsecaea pedrosoi that developed after corneal trauma.
A 18-year-old male presented with a corneal ulcer in the right eye, 28 days after a trauma with glass fragments. Corneal scrapings were collected for smears and culture. Dematiaceous hyphae were seen on wet mounts of the scrapings and dark pigmented colonies grew repetitively on the culture media; all colonies were identical, and were subsequently identified as Fonsecaea pedrosoi. Treatment was initiated with topical natamycin at one hour intervals, 200 mg oral ketoconazole per day and later changed to a combination of 200 mg ketoconazole and amphotericin B. In humid tropical regions Fonsecaea pedrosoi is one of the primary causes of human chronic cutaneous mycosis, chromoblastomycosis. Combination of systemic and topical antifungal medications may provide the best option for cure in corneal chromoblastomycosis.
报告一例角膜外伤后发生的由裴氏瓶霉引起的真菌性角膜炎罕见病例。
一名18岁男性在被玻璃碎片划伤28天后，右眼出现角膜溃疡。采集角膜刮片进行涂片和培养。在刮片的湿片中可见暗色丝孢菌菌丝，在培养基上反复长出深色色素沉着菌落；所有菌落均相同，随后鉴定为裴氏瓶霉。开始治疗时，每小时局部应用那他霉素，每天口服200毫克酮康唑，之后改为200毫克酮康唑和两性霉素B联合使用。在潮湿的热带地区，裴氏瓶霉是人类慢性皮肤真菌病、着色芽生菌病的主要病因之一。全身和局部抗真菌药物联合使用可能是治疗角膜着色芽生菌病的最佳选择。
