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D.A. Goldman, D. Miller, E.C. Alfonso; Voriconazole in the Treatment of Aspergillus Glaucus Corneal Ulcer . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3560.
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To demonstrate the efficacy of topical 1% voriconazole in the treatment of fungal keratitis with clinical history and photos.
A 24 year old male with 1 week history of decreased vision non–responsive to vigamox, gentamicin, and vancomycin was referred to the Bascom Palmer Eye Institute for evaluation. Cultures were performed and the patient was started on natamycin secondary to hyphal elements on gram stain. The patient's condition continued to deteriorate and several days later the cultures grew aspergillus glaucus, a fungus with known resistance to all commercially available antifungal agents. 1% topical voriconazole was compounded by the hospital pharmacy and given to the patient to use in addition to oral voriconazole.
The patient's infiltrate decreased significantly in size and the infection was sucessfully eradicated.
Topical voriconazole is an effective alternative treatment for fungal keratitis. It may be considered a first–choice agent in keratitis secondary to natamycin–resistant organisms such as aspergillus glaucus.
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