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Fusarium solani keratitis: role of antifungal susceptibility testing and identification to the species level for proper management
Rosa, Priscila Dallé; Sheid, Karla; Locatelli, Claudete; Marinho, Diane; Goldani, Luciano.
  • Rosa, Priscila Dallé; Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Medicina: Ciências Médicas. Rio Grande do Sul. BR
  • Sheid, Karla; Hospital de Clínicas de Porto Alegre. Serviço de Oftalmologia. Porto Alegre. BR
  • Locatelli, Claudete; Hospital de Clínicas de Porto Alegre. Serviço de Oftalmologia. Porto Alegre. BR
  • Marinho, Diane; Hospital de Clínicas de Porto Alegre. Serviço de Oftalmologia. Porto Alegre. BR
  • Goldani, Luciano; Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Medicina: Ciências Médicas. Rio Grande do Sul. BR
Braz. j. infect. dis ; 23(3): 197-199, May-June 2019. graf
Article in English | LILACS | ID: biblio-1019556
ABSTRACT
ABSTRACT We report a patient with fungal keratitis caused by a multiresistant Fusarium solani in a tertiary care hospital located in southern Brazil. A 55-year-old man with a history of ocular trauma presented with keratitis in left eye. The patient has a complicated clinical course and failed to respond to local and systemic antifungal treatment, and required eye enucleation. Despite multiple topical, intraocular and systemic antifungal treatments, hyphal infiltration persisted in the corneal transplant causing continuous recurrences. The cultures of corneal biopsy scrapings were positive for Fusarium spp. The organism was identified to species level by multi-locus sequencing for translation elongation factor 1 alpha (EF-1α), and RNA polymerase II subunit (RPB2). In vitro antifungal susceptibility testing of the isolate by the broth microdilution method, according to CLSI M38-A2, disclosed susceptibility to natamycin and resistance to amphotericin B, voriconazole, itraconazole and fluconazole. Considering previous unsuccessful antifungal treatments due to multiple drug resistance, the eye was enucleated. Our case report illustrates that management of fungal keratitis remains a therapeutic challenge. Optimal treatment for F. solani infection has not yet been established and should include susceptibility testing for different antifungal agents.
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Full text: Available Index: LILACS (Americas) Main subject: Fusarium / Keratitis / Antifungal Agents Type of study: Diagnostic study / Prognostic study Limits: Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital de Clínicas de Porto Alegre/BR / Universidade Federal do Rio Grande do Sul/BR

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Full text: Available Index: LILACS (Americas) Main subject: Fusarium / Keratitis / Antifungal Agents Type of study: Diagnostic study / Prognostic study Limits: Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital de Clínicas de Porto Alegre/BR / Universidade Federal do Rio Grande do Sul/BR