Infectious endotheliitis: a rare case of presumed mycotic origin
Luis Fernando Zapata,1 José David Paulo,1 Carlos A Restrepo,1 Luis Fernando Velásquez,2 Andrés E Toro Montoya,2 Melissa A Zapata21Department of Ophthalmology Hospital Pablo Tobón Uribe; 2School of Medicine, Universidad Pontificia Bolivariana, Medell&ia...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2013
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| Acceso en línea: | https://doaj.org/article/2f49dde375f7433e95382240327bccf8 |
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| Sumario: | Luis Fernando Zapata,1 José David Paulo,1 Carlos A Restrepo,1 Luis Fernando Velásquez,2 Andrés E Toro Montoya,2 Melissa A Zapata21Department of Ophthalmology Hospital Pablo Tobón Uribe; 2School of Medicine, Universidad Pontificia Bolivariana, Medellín, ColombiaPurpose: To report an interesting case of infectious endotheliitis of presumed mycotic origin.Methods: A case report of a 56-year-old male farmer who sought medical attention after a month-long evolution of irritative symptoms in his right eye, accompanied by visual acuity (VA) impairment. The patient received topical and oral broad-spectrum antibiotic treatment with no improvement before being referred to a cornea specialist, where he was found to have VA of 20/150 and was noted on biomicroscopy to have endothelial feathery coalescent lesions. The patient was admitted to the hospital for an aqueous humor sample and intravenous voriconazole.Results: The microbiological studies did not isolate any micro-organisms. However, clinical evidence of improvement was confirmed after 5 days of antimycotic intravenous therapy. Complete clinical resolution was achieved at 1 month after treatment completion with oral voriconazole, as evidenced by VA of 20/20 and disappearance of endothelial lesions.Conclusion: Endothelial involvement by fungi is a rare condition. In this case, no microbes were isolated, but the characteristic morphology of the lesions, the history of onychomycosis, and the spectacular response to voriconazole turn this case into a valid presumptive diagnosis.Keywords: endotheliitis, mycotic, keratitis, voriconazole |
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