Severe fusarium oxysporum keratomycosis: About 2 Cases

Jihad Branya, Youssef Kfal, Soukaina Adadi, Z. Tlamçani, Mohamed Himmich, Ahmed Bennis, F. Chraibi, Meriem Abdellaoui, Idriss Benatiya Andaloussi
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Abstract

Fungal keratitis is a destructive ocular infection, representing a serious diagnostic and therapeutic problem, difficult to treat and with poor results. It can cause irreversible damage. Keratomycoses are rare and may be under-diagnosed. Direct microscopic examination and culture are essential for early specific diagnosis and must be taken into consideration to establish the most effective treatment and avoid serious complications. The pathogenesis of this infection is based on three factors: colonization, tissue damage and immunosuppression. We report 2 cases of Fusarium oxysporum keratomycosis treated with amphotericin B. The diagnosis of corneal abscess was made after ophthalmological examination in 2 adult males with no previous ophthalmological history, referred to the Omar Drissi hospital in Fez for decreased visual acuity, photophobia, redness and intense pain in the right/left eye. Corneal scrapings were taken for microbiological analysis, and after initial mycological results, local and systemic antifungal treatment was initiated with amphotericin B and natamycin eye drops. The evolution was marked by a corneal perforation with a tenon patch graft for the first patient, and healing for the 2nd
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严重的恶孢镰刀菌角化病约 2 个病例
真菌性角膜炎是一种破坏性眼部感染,是一个严重的诊断和治疗问题,治疗困难且效果不佳。它可能造成不可逆转的损害。真菌性角膜炎很少见,而且可能诊断不足。直接显微镜检查和培养对早期特异性诊断至关重要,必须考虑到这一点才能确定最有效的治疗方法,避免严重的并发症。这种感染的发病机制基于三个因素:定植、组织损伤和免疫抑制。我们报告了两例用两性霉素 B 治疗的镰刀菌角膜霉菌病病例。这两名成年男性既往无眼科病史,因视力下降、畏光、右眼/左眼发红和剧烈疼痛而转诊至非斯的 Omar Drissi 医院,经眼科检查后确诊为角膜脓肿。在得出初步的真菌学结果后,医生开始使用两性霉素 B 和纳他霉素滴眼液进行局部和全身抗真菌治疗。病情发展的特点是,第一名患者的角膜穿孔,需要进行腱膜贴片移植,第二名患者的角膜穿孔愈合,第三名患者的角膜穿孔愈合。
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