2010 OMIG, Abstract 16

OMIG Main Page | 2010 Abstracts | < Previous| Next >

Metarrhizium anisopliae keratitis 
H. Ahmadi, D.G. Heidemann, S.P. Dunn, C. Y. C. Chow,
Oakland University - William Beaumont Hospital, Royal Oak, MI

Purpose: To report a case of fungal keratitis in the northern United States (U.S.) caused by Metarrhizium anisopliae and discuss its antifungal sensitivity profile and clinical responsiveness.
Method: Case report.
Results: A 36-year-old male who wore extended-wear soft contact lenses developed a recalcitrant corneal ulcer.  Cultures eventually grew Metarrhizium anisopliae.  Treatment with topical amphotericin B drops was ineffective.  The fungus was noted to have an MIC (ug/ml) >16 for amphotericin and natamycin, and an MIC of 2 for voriconazole.  The ulcer improved and eventually healed after adding topical and oral voriconazole. 
Conclusion: Metarrhizium anisopliae is a rare cause of keratitis.  We report the fourth case, and the first case to test in-vitro susceptibility. This patient did not respond to topical amphotericin B, but responded promptly to topical and systemic voriconazole. In addition, the case was remarkable for severe, recalcitrant pain, which persisted for one month after marked clinical improvement of the keratitis. 

Disclosure Code:  N