Keratomycosis due to Fusarium oxysporum treated with the combination povidone iodine eye drops and oral fluconazole

• Published in: Journal de mycologie médicale Vol. 25; no. 4; pp. e134 - e137
• Main Authors: Diongue, K, Sow, A S, Nguer, M, Seck, M C, Ndiaye, M, Badiane, A S, Ndiaye, J M, Ndoye, N W, Diallo, M A, Diop, A, Ndiaye, Y D, Dieye, B, Déme, A, Ndiaye, I M, Ndir, O, Ndiaye, D
• Format: Journal Article
• Language: French
• Published: France 01-12-2015
• Subjects: Administration, Oral; Adult; Corneal Ulcer - drug therapy; Corneal Ulcer - microbiology; Drug Therapy, Combination; Eye Infections, Fungal - drug therapy; Eye Infections, Fungal - microbiology; Fluconazole - administration & dosage; Fusarium - isolation & purification; Fusarium - physiology; Humans; Male; Ophthalmic Solutions; Povidone-Iodine - administration & dosage; Kératite fongique; Fusarium oxysporum; Fluconazole; Dantec; Povidone iodée; Povidone iodine; Fungal keratitis
• ISSN: 1773-0449
• DOI: 10.1016/j.mycmed.2015.10.006

In developing countries where systemic antifungal are often unavailable, treatment of filamentous fungi infection as Fusarium is sometimes very difficult to treat. We report the case of a keratomycosis due to Fusarium oxysporum treated by povidone iodine eye drops and oral fluconazole. The diagnosis of abscess in the cornea was retained after ophthalmological examination for a 28-year-old man with no previous ophthalmological disease, addressed to the Ophthalmological clinic at the University Hospital Le Dantec in Dakar for a left painful red eye with decreased visual acuity lasting for 15 days. The patient did not receive any foreign body into the eye. Samples by corneal scraping were made for microbiological analysis and the patient was hospitalized and treated with a reinforced eye drops based treatment (ceftriaxone+gentamicin). The mycological diagnosis revealed the presence of a mold: F. oxysporum, which motivated the replacement of the initial treatment by eye drops containing iodized povidone solution at 1% because of the amphotericin B unavailability. Due to the threat of visual loss, oral fluconazole was added to the local treatment with eye drops povidone iodine. The outcome was favorable with a healing abscess and visual acuity amounted to 1/200th. Furthermore, we noted sequels such as pannus and pillowcase. The vulgarization of efficient topical antifungal in developing countries would be necessary to optimize fungal infection treatment.