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BRIEF COMMUNICATION
Year : 2017  |  Volume : 65  |  Issue : 6  |  Page : 523-526

Surgical treatment of Metarhizium anisopliae sclerokeratitis and endophthalmitis


1 Department of Ophthalmology, Strasbourg University Hospital, FMTS, University of Strasbourg, 67000 Strasbourg, France
2 Parasitology and mycology laboratory, Strasbourg University Hospital; Institute of Parasitology and Tropical Diseases, Strasbourg University, 67000 Strasbourg, France

Correspondence Address:
Dan Derhy
Department of Ophthalmology, NHC, Strasbourg University Hospital, BP 426, 67091 Strasbourg
France
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_461_16

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A 55-year-old nurse was referred with a 5-month history of right eye corneal abscess. The initial injury occurred when doing lawn work. The infection worsened despite multiple antibiotic, antiviral, and steroid treatments. Visual acuity was limited to hand motion. On examination, there was keratitis, ocular hypertension, and a secondary cataract. Corneal scrapings grew a filamentous fungus, identified as Metarhizium anisopliae (MA). Despite intensive antifungal treatment with topical, intravitreous, and systemic voriconazole, purulent corneal melting and scleritis with endophthalmitis rapidly appeared. An emergency surgical procedure including sclerocorneal transplantation, cataract surgery, a pars plana vitrectomy using temporary keratoprosthesis, and scleral crosslinking was necessary. One year after the surgery, there was no recurrence of infection. Functional outcome remained very poor. This is the first case of sclerokeratitis and endophthalmitis caused by MA ever reported. The infection was successfully treated with an aggressive combination of medical and surgical treatments.


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