[Efficiency of voriconazole in fungal keratitis caused by candida albicans]. / Eficacia del voriconazol en queratitis fúngica por cándida albicans.

CASE REPORT: A 70-year-old woman, with a history of diabetes and persistent corneal ulceration, developed a severe keratitis caused by Candida albicans. It evolved rapidly to corneal perforation in spite of treatment with topical amphotericin B and oral itraconazole. An amniotic membrane transplant was performed as an emergency, associated with systemic administration of voriconazole. The infection was solved successfully, although the patient needed a penetrating keratoplasty to restore the corneal transparency. DISCUSSION: Fungal keratitis caused by Candida albicans usually follows an aggressive course and may simulate a bacterial aetiology. Voriconazole is a new antifungal drug that appears to be very effective in the management of ocular infections caused by many filamentous and levaduriform fungi.

Eficacia del voriconazol en queratitis fúngica por Cándida Albicans / Efficency of voriconazole in fungal kerititis caused by Candida Albicans

Caso clínico: Mujer de 70 años de edad, con antecedentes de diabetes y ulceración corneal persistente, que desarrolló una queratitis grave por Candida albicans. Evolucionó rápidamente hacia la perforación corneal a pesar del tratamiento con anfotericina B tópica e itraconazol oral, realizándose de urgencia un trasplante de membrana amniótica asociado a administración sistémica de voriconazol. La infección se resolvió satisfactoriamente, aunque precisó después una queratoplastia penetrante para restaurar la transparencia corneal. Discusión: Las queratitis fúngicas causadas por Candida albicans suelen cursar de una forma agresiva y simulan una etiología bacteriana. El voriconazol es un nuevo fármaco antifúngico que parece ser muy eficaz en el tratamiento de infecciones oculares causadas por numerosos hongos, tanto filamentosos como levaduriformes(AU)

Case report: A 70-year-old woman, with a history of diabetes and persistent corneal ulceration, developed a severe keratitis caused by Candida albicans. It evolved rapidly to corneal perforation in spite of treatment with topical amphotericin B and oral itraconazole. An amniotic membrane transplant was performed as an emergency, associated with systemic administration of voriconazole. The infection was solved successfully, although the patient needed a penetrating keratoplasty to restore the corneal transparency. Discussion: Fungal keratitis caused by Candida albicans usually follows an aggressive course and may simulate a bacterial aetiology. Voriconazole is a new antifungal drug that appears to be very effective in the management of ocular infections caused by many filamentous and levaduriform fungi(AU)