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Verfasst von:Thomas, Bettina C. [VerfasserIn]   i
 Zimmermann, Stefan [VerfasserIn]   i
 Völcker, Hans Eberhard [VerfasserIn]   i
 Auffarth, Gerd U. [VerfasserIn]   i
 Dithmar, Stefan [VerfasserIn]   i
Titel:Severe Arthrographis kalrae keratomycosis in an immunocompetent Patient
Verf.angabe:Bettina C. Thomas, MD, Stefan Zimmermann, MD, Hans-Eberhard Völcker, MD, Gerd U. Auffarth, MD, and Stefan Dithmar, MD
Jahr:2011
Umfang:3 S.
Fussnoten:Gesehen am 02.11.2022
Titel Quelle:Enthalten in: Cornea
Ort Quelle:Philadelphia, Pa. : Lippincott, Williams & Wilkins, 1982
Jahr Quelle:2011
Band/Heft Quelle:30(2011), 3 vom: März, Seite 364-366
ISSN Quelle:1536-4798
Abstract:Purpose: - To describe a severe case of keratomycosis caused by Arthrographis kalrae requiring repeated keratoplasty. - Methods: - A 42-year-old otherwise healthy soft contact lens wearer developed a unilateral central corneal ulcer. Treatment with topical and systemic voriconazole is described. - Results: - Repeated microbiological testing of ocular swabs (culture) initially yielded Candida albicans. Under treatment with topical clotrimazole, the ulcer progressed, and a corneal perforation required a keratoplasty à chaud. For prophylaxis, the patient received fluconazole systemically and continuous topical clotrimazole. However, in 2 weeks time, the mycotic infiltrates penetrated the corneal transplant and led to a second keratoplasty only 1 month after the first one. In the meantime, the microbiological analysis of the first keratoplasty revealed A. kalrae, which was sensitive to voriconazole. High-dose serum level-controlled systemic voriconazole and topical voriconazole were able to stabilize, but not eliminate the infection. About 1 year after the start of the voriconazole therapy, treatment had to be discontinued because of side effects. Mycotic infiltrates increased, and even an intracameral voriconazole injection could not prevent a third and a fourth keratoplasty. - Conclusions: - Ocular infection with A. kalrae is very rare. The microbiological differentiation of A. kalrae can be difficult. Because a broad spectrum of fungi is sensitive to voriconazole, the early topical and possibly systemic treatment is a reasonable therapeutic option when a mycotic infection of the eye is suspected, even before the causative fungus is identified.
DOI:doi:10.1097/ICO.0b013e3181eadeb9
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1097/ICO.0b013e3181eadeb9
 Volltext: https://journals.lww.com/corneajrnl/Fulltext/2011/03000/Severe_Arthrographis_kalrae_Keratomycosis_in_an.23.aspx
 DOI: https://doi.org/10.1097/ICO.0b013e3181eadeb9
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1820521516
Verknüpfungen:→ Zeitschrift

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