Management of Rare Fungal Keratitis Caused by Fonsecaea Pedrosoi
Purpose
to discuss the evaluation of an unusual corneal chromoblastomycosis due to the fungus Fonsecaea pedrosoi.
Methods
case report of a patient with corneal infection by F. pedrosoi admitted at the emergency service of the Santa Casa de Belo Horizonte and its approach in regards of the few similar cases reported by the literature.
Results
a corneal ulcer, initially treated with topical antibiotics, showed no improvement and slowly progressed. Microbiological test isolated the agent F. pedrosoi. Topical treatment with amphotericin B 0,25% was initiated. After a few days, topical natamycin 5% and oral fluconazole 150mg/day were associated. The treatement improved signs and symptoms and case resolution was seen after 5 weeks. After 7 months with no further medication, the patient evolved with no inflammatory signs, a corneal thinning at the site of the lesion and a good visual acuity.
Conclusion
Despite of F. pedrosoi being the most common agent of cutaneous blastomycosis, there are few reports of ocular infection by this agent in the literature with no consense regarding a gold-standart therapeutic. According to our follow up, the use of natamycin with amphotericin B and oral fluconazole showed good results.