Recalcitrant Beauveria bassiana Keratitis

Tu, Elmer Y.; Park, Anna J

doi:10.1097/ico.0b013e3180de4953

Cited by 43 publications

(12 citation statements)

References 11 publications

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“…The course of our non-necrotic keratitis case was slow-growing, there was no clinical improvement after treatment with voriconazole even though voriconazole was the preferable antibiotic according to the sensitivity tests. The cases of B. bassiana reported by Low et al , Kisla et al , and Tu et al , were also slow-growing with late penetration into the corneal stroma which is consistent with our case [ 6 , 7 , 12 ]. In addition, the resistance to antifungal therapy was also consistent with our case [ 6 – 8 , 12 ].…”

Section: Discussionsupporting

confidence: 92%

Fungal keratitis caused by Beauveria bassiana: drug and temperature sensitivity profiles: a case report

et al. 2014

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BackgroundBeauveria bassiana is an entomopathogenic fungus and is a rare cause of keratitis. We present a case of fungal keratitis caused by B. bassiana that was diagnosed by in vivo confocal microscopy and in vitro corneal cultures. In addition, we determined the temperature- and drug-sensitivities of the isolated strain of B. bassiana.Case presentationA 59-year-old Japanese man with a 2-month history of keratitis was examined by slit-lamp biomicroscopy, in vivo confocal microscopy, and histology and cultures of corneal scrapings. The corneal scrapings were used to determine the minimal inhibitory concentrations of different antifungal drugs and also to determine the temperature-sensitivity. In vivo confocal microscopy and histological examinations showed filamentous fungal keratitis. The characteristics of the fungal growth indicated that the keratitis was caused by B. bassiana. The keratitis responded poorly to systemic and topical voriconazole and to natamycin ointment. However, it was resolved after changing the natamycin to micafungin combined with surgical debridement. The isolated strain was sensitive to itraconazole, miconazole, micafungin, voriconazole, and resistant to flucytosine and fluconazole. It was moderately sensitive to amphotericin B, and natamycin. After 7 days in culture, the isolate grew small white colonies at 25°C, very small colonies at 35°C and 37°C.ConclusionThe drug-sensitivity and temperature-sensitivity profiles of B. bassiana should be helpful in the treatment of B. bassiana keratitis. Therapeutic surgery may be helpful for mycotic keratitis poorly responsive to medical therapy alone.

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Section: Discussionsupporting

confidence: 92%

Fungal keratitis caused by Beauveria bassiana: drug and temperature sensitivity profiles: a case report

et al. 2014

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“…The in vivo response shows a stabilization of the corneal lesion, allowing amphotericin B to inhibit worsening of the disease as seen in previous reports 22.…”

Section: Case Reportsupporting

confidence: 77%

A case of Beauveria bassiana keratitis confirmed by internal transcribed spacer and LSU rDNA D1–D2 sequencing

Ligozzi

Maccacaro

Passilongo

et al. 2014

New Microbes and New Infections

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“…8 Its efficacy on Paecilomyces lilacinus has recently been shown in a murine infection model. 10 In addition, it has recently been used in a case with refractory keratitis due to Beauvaria bassiana , as reported by Tu et al 11 Further, Sponsel et al successfully treated a case of Fusarium keratitis, where posaconazole was used both orally and topically. 12 However, the commercial preparation of posaconazole available now is an oral suspension and should not be used topically as it contains various additives, including dyes.…”

Section: Discussionmentioning

confidence: 97%

“…Tu et al reported that posaconazole had to be discontinued after one month of therapy due to the development of elevated liver function tests and pleural effusion. 11 …”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Paecilomyces lilacinus Keratitis With Oral Posaconazole

Arnoldner

Kheirkhah

Jakobiec

et al. 2014

Cornea

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Purpose To report a case of successful medical treatment with oral posaconazole in refractory fungal keratitis caused by Paecilomyces lilacinus. Methods Case report. Results A 57-year-old male soft contact lens wearer presented with irritation, pain, photophobia and reduced vision. Slit-lamp examination showed a large corneal epithelial defect with a peripheral infiltrate. The patient did not improve on fortified topical antibiotics. Following diagnosis of Paecilomyces lilacinus fungal keratitis, oral voriconazole and topical antifungal therapy were started. Despite antifungal therapy, progressive disease required therapeutic penetrating keratoplasty (PKP). Postoperatively, due to clinical signs of recurrence and in vivo confocal microscopy (IVCM) findings of presumed hyphae in the cornea, intracameral miconazole was injected and oral posaconazole was started. The patient improved and demonstrated no hyphae 6 weeks after starting posaconazole. When posaconazole was stopped the cornea remained clear with excellent acuity. However, due to acute graft rejection 2 months after stopping posaconazole, keratoprosthesis was implanted, with no evidence of infection at surgery or during 3.5 years follow-up. Conclusion To our knowledge, this is the first report on the use of oral posaconazole for Paecilomyces keratitis. Posaconazole might be indicated in the treatment of refractory Paecilomyces keratitis resistant to conventional therapy.

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Recalcitrant Beauveria bassiana Keratitis

Cited by 43 publications

References 11 publications

Fungal keratitis caused by Beauveria bassiana: drug and temperature sensitivity profiles: a case report

Fungal keratitis caused by Beauveria bassiana: drug and temperature sensitivity profiles: a case report

A case of Beauveria bassiana keratitis confirmed by internal transcribed spacer and LSU rDNA D1–D2 sequencing

Successful Treatment of Paecilomyces lilacinus Keratitis With Oral Posaconazole

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