Abstract
Purpose :
Purpuriocillium sp are filamentous saprophytic fungi found worldwide. Half of all reported infections affect the eye, and many are refractory to conventional anti-fungal agents.
Methods :
Methods: We have performed a retrospective study between 1995-2015 of 21 patients developing P. keratitis in São Paulo’s hospital. The strain was identified and isolated in 13 cases, which were submitted to the Minimum Inhibitory Concentration (MIC) and analyze the most common antifungal drugs against the Purpuriocillium lilacinus
Results :
Results: Most cases developed this infection after eye surgery (66.7%), followed by contact lens (13.3%) and ocular trauma (6.64%). The main topical treatment drugs were amphotericin B 0,15% (100%) and intracameral injection (66.7%). However, the patients kept worsening and were submitted to keratoplasty (53%). The majority of antifungigram results showed elevated MIC regarding itraconazole (16µg/mL) and amphotericin B (16µg/mL) and sensibility to voriconazole (0,25µg/mL) and posaconazole (1µg /mL).
Conclusions :
Conclusion: P. lilacinus keratitis does not respond reliably to most frequently applied anti-fungal treatment, demanding therapeutic keratoplasty. Voriconazole and posaconazole were considered the best anti-fungal drugs for the treatment of Purpureocillium lilacinus keratitis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.