医学
伏立康唑
土曲霉
巩膜炎
外科
皮肤病科
眼科
抗真菌
食品科学
化学
葡萄膜炎
作者
Antonio Hernández-Pons,Amparo Ortiz-Seller,Ian López‐Cruz,Juan J. Camarena,Alberto Comín-Pérez,María A Ferrández-Pérez,L. Martínez-Costa
出处
期刊:Cornea
[Ovid Technologies (Wolters Kluwer)]
日期:2021-01-26
卷期号:Publish Ahead of Print
被引量:1
标识
DOI:10.1097/ico.0000000000002670
摘要
To report a case of infectious necrotizing scleritis secondary to Aspergillus terreus after intravitreal injection therapy.This is a case report with literature review.A 98-year-old woman receiving intravitreal aflibercept injections for neovascular age-related macular degeneration in the left eye presented with severe pain, redness, and purulent discharge at the injection site. She was initially treated with topical fortified antibiotics, and clinical improvement was achieved, although microbial cultures showed negative results. Two months later, she presented with severe ocular pain and was diagnosed with anterior necrotizing scleritis. Scleral scrapings were collected for cultures, and intensive topical antibiotic therapy was reintroduced. Evaluation for autoimmune etiology and microbiological testing showed negative results. Because of the progression of the scleral necrotic area, empirical therapy with topical voriconazole was initiated, and surgical debridement was performed. Finally, the culture was positive for A. terreus. The modified therapy consisted of topical voriconazole and oral voriconazole for 3 months with an excellent clinical outcome.To our knowledge, this is the first case of fungal necrotizing scleritis secondary to intravitreal injection. Diagnosis was delayed due to its chronic clinical course and the slow fungal growth in culture media, but the combined medical and surgical approach resulted in a satisfactory outcome.
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