International Ophthalmology

, Volume 30, Issue 1, pp 103–107

Fusarium keratitis and endophthalmitis associated with lens contact wear

  • Julia Proença-Pina
  • Isabelle Ssi Yan Kai
  • Tristan Bourcier
  • Monique Fabre
  • Hervé Offret
  • Marc Labetoulle
Case Report

DOI: 10.1007/s10792-008-9290-7

Cite this article as:
Proença-Pina, J., Ssi Yan Kai, I., Bourcier, T. et al. Int Ophthalmol (2010) 30: 103. doi:10.1007/s10792-008-9290-7
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Abstract

IntroductionFusarium keratitis is a severe corneal infection that is usually seen in tropical and subtropical countries after a corneal trauma. In 2005–2006, an epidemic of Fusarium keratitis, occurring predominantly among contact lens wearers, was observed in several countries. Case report We describe the clinical course of a Fusarium keratitis which failed to respond to systemic and local voriconazole treatment, and experienced a progression to a severe keratitis with endophthalmitis, requiring early therapeutic keratoplasty (“à chaud”). After 8 months of follow up, the vision recovered to 20/50. Discussion After the 2005–2006 worldwide epidemics, case–control studies pointed out that a new lens care solution, ReNu with MoistureLoc® (Bausch & Lomb™), was likely responsible of numerous cases. Complementary studies underlined that this infection mostly concerned non-compliant patients, i.e., those reusing the solution several times, since this results in a decrease of the antifungal activity due to the uptake of the biguanides into the lens. ConclusionFusarium endophtalmitis can result in a devastating disease with a poor visual outcome. An initial antifungal dual therapy may control the infection. In case of failure, an early keratoplasty may be mandatory. For contact lens wearers, education on sanitary good practice is necessary to avoid new epidemics in the future.

Keywords

Amphotericin B Endophthalmitis Fusarium solani Multipurpose lens care solution ReNu with MoistureLoc® Voriconazole 

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Julia Proença-Pina
    • 1
  • Isabelle Ssi Yan Kai
    • 1
  • Tristan Bourcier
    • 2
  • Monique Fabre
    • 3
  • Hervé Offret
    • 1
  • Marc Labetoulle
    • 1
    • 4
  1. 1.Department of Ophthalmology, Bicêtre University Hospital, APHPUniversity Paris XIParisFrance
  2. 2.Ophthalmology DepartmentStrasbourg University HospitalStrasbourgFrance
  3. 3.Department of Pathology, Bicêtre University Hospital, APHPUniversity Paris XIParisFrance
  4. 4.CHU de BicêtreParisFrance

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