Candida parapsilosis keratitis treated successfully with topical and oral fluconazole

Abstract

A 73-year-old male patient presented with ocular pain, redness, and blurred vision in the left eye, which had been ongoing for more than 2 months. An oval-shaped paracentral corneal ulcer with stromal infiltration and a mild anterior chamber reaction were found. Despite treatment with empiric antibiotics, the lesion progressed and corneal thinning in the middle area was noted. The culture yielded Candida parapsilosis. We therefore prescribed topical 0.2% fluconazole (FCZ) in combination with oral FCZ as an antifungal treatment, following which the stromal infiltration gradually subsided. Complete epithelial-ization was noted on the 8th day after initiating FCZ therapy. There was no recurrent disease in the subsequent 2 years. Our case demonstrates that topical FCZ 0.2% in combination with oral FCZ can successfully treat C. parapsilosis keratitis and result in a good visual outcome.

Cyclodextrin Stabilized Freeze-Dried Silica/Chitosan Nanoparticles for Improved Terconazole Ocular Bioavailability

“…Previously, the first line to treat fungal keratitis was through the topical administration of amphotericin B, however patients suffered from poor vision as a result of this. Moreover, in some complicated cases, corneal grafts were required [ 9 ]. Alternative approaches for using topical amphotericin B were introduced, namely, the utilization of topical azoles.…”

Descemet membrane endothelial keratoplasty for treatment of iridocorneal endothelial syndrome

“…Adequate therapy should be based on susceptibility profiling of isolated organisms and combined oral and topical azole therapy is an effective modality for superficial corneal fungal infections. 13…”

Efficacy of a Fixed Combination of Tetracycline, Chloramphenicol, and Colistimethate Sodium for Treatment of Candida albicans Keratitis

“…They have better ocular penetration and are less toxic to the corneal epithelium, compared with amp B. [9][10][11] The clinician must determine the length of treatment for each case based on clinical response and experience. Treatment with a systemic antifungal agent is recommended in cases of severe deep keratitis, scleritis, and endophthalmitis.…”