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Provedor de dados:  BJID
País:  Brazil
Título:  Fusarium solani keratitis: role of antifungal susceptibility testing and identification to the species level for proper management
Autores:  Rosa,Priscila Dallé
Sheid,Karla
Locatelli,Claudete
Marinho,Diane
Goldani,Luciano
Data:  2019-06-01
Ano:  2019
Palavras-chave:  Keratitis
Corneal ulcer
Fusarium solani
Antifungal agents resistance
Resumo:  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.
Tipo:  Info:eu-repo/semantics/report
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702019000300197
Editor:  Brazilian Society of Infectious Diseases
Relação:  10.1016/j.bjid.2019.05.002
Formato:  text/html
Fonte:  Brazilian Journal of Infectious Diseases v.23 n.3 2019
Direitos:  info:eu-repo/semantics/openAccess
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