2010 OMIG, Abstract 15

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Exophiala jeanselmei keratitis: case report and review of literature
O.J. Saeedi, S. Iyer, R. N. Hogan, Dept. of Ophthalmology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX

Purpose:To describe a patient with Exophiala jeanselmei keratitis and to review the prior cases reported in the literature. 
Methods: We report one patient with keratitis after remote injury and chronic steroid use and review the five prior reported cases.
Results: Culture plates from corneal scraping revealed growth of the dematiaceous fungi, Exophiala jeanselmei, a rare causative organism of ocular infection.  The patient underwent therapy with topical and intracameral antifungals and subsequently required a corneal transplant.  Pathology of the donor graft confirmed the diagnosis of Exophiala jeanselmei.  This is the first reported case to use intracameral antifungal agents and the first biopsy proven case.  Half of reported cases had associated trauma and severity was generally related to delay in diagnosis.  
Conclusions: Trauma and chronic topical steroid use contributed to the development of severe keratitis in this patient.  Patients on chronic steroids should be monitored closely.  Topical, subconjunctival, and intracameral antifungals have all been effective in treating this pathogen.  If diagnosed and treated early, Exophiala jeanselmei keratitis can have a good visual outcome.

Disclosure Code:  N