Keratitis by Scopulariopsis brevicaulis Fungus After LASIK – A C


Pedro Manuel Baptista,1,2 Rita Vieira,1 Sílvia Monteiro,1 Ana Carolina Abreu,1 Miguel Gomes,1,2 Maria do Céu Pinto Snr1

1Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal

Correspondence: Pedro Manuel Baptista
Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, Porto, 4099-001, Portugal
Tel +35-1917868372
Email [email protected]

Purpose: To describe a rare case of an interface filamentous fungal keratitis and its successful clinical approach and management.
Patients and Methods: Retrospective case report. Analysis of the patient’s clinical records.
Results: A healthy 30-year-old woman presenting with complaints of blurred vision, photophobia and intense pain, was previously diagnosed with a suspected unilateral diffuse lamellar keratitis after laser in situ keratomileusis surgery, and accordingly treated with a scheme of oral and subconjunctival corticosteroids. Due to worsening of symptoms, the patient was later referred to our ophthalmology department. Upon examination, a corneal infiltration was observed and a fungal infection was suspected. Treatment with fortified Voriconazole (1%) was initiated and both topical and oral corticosteroids were tapered. The infiltrate resolved after 6 weeks of antifungal topical treatment. Scopulariopsis brevicaulis was isolated on culture media. At the end of follow-up, the uncorrected distance visual acuity was 20/20 with mild scarring.
Conclusion: Scopulariopsis brevicaulis can be associated with post-laser in situ keratomileusis interface infection. A quick intervention may dictate a good outcome, when combining early suspicion and microbiological diagnosis, and an appropriate conservative management. Furthermore, Voriconazole seems to be effective and safe in the treatment of such cases.

Keywords: fungus, keratitis, laser in situ keratomileusis, Scopulariopsis brevicaulis, laser vision correction

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