J Korean Ophthalmol Soc.  2010 Sep;51(9):1271-1275. 10.3341/jkos.2010.51.9.1271.

Three Cases of Secondary Fungal Infection in Herpes Simplex Keratitis

• Mun GH
• Park YG
• You IC
• Yoon KC

• KMID: 2122296
• DOI: http://doi.org/10.3341/jkos.2010.51.9.1271

Abstract

PURPOSE
To report several cases of secondary infection by fungus in herpes simplex keratitis.
CASE SUMMARY
A retrospective chart review was performed on 3 eyes of 3 patients who were without improvement and diagnosed with fungal keratitis by smear and culture on prior presentation with herpetic keratitis. Two cases were diagnosed with fungal keratitis, based on the results of culture. Fungal keratitis by Candida albicans was improved with antifungal agents, but a case caused by Fusarium species was more aggravated, regardless of antifungal agents. One case was improved by antifungal medications, which was diagnosed with fungal keratitis by the fungal hyphae manifestation on KOH preparation.
CONCLUSIONS
Secondary microbial infection should be considered, when the lesion had no improvement with antiviral agents in herpetic keratitis.

Keyword

Fungus; Herpetic keratitis; Secondary infection

MeSH Terms

Antifungal Agents
Antiviral Agents
Candida albicans
Coinfection
Eye
Fungi
Fusarium
Herpes Simplex
Humans
Hyphae
Keratitis
Keratitis, Herpetic
Methylmethacrylates
Polystyrenes
Retrospective Studies
Antifungal Agents
Antiviral Agents
Methylmethacrylates
Polystyrenes

Figure

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  Figure 1. Case 1. (A) At the initial visit, slit lamp photograph showed 2.0×1.5 mm sized geographic ulcer and stromal infiltration with hypopyon. (B) After 2 weeks, stromal infiltration associated with epithelial defect and hypopyon increased. (C) After 4 months of antifungal treatment, corneal lesions regressed.

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  Figure 2. Case 2. (A) At the initial visit, slit lamp photograph revealed dendritic lesion in the upper paracentral cornea. (B) After 2 weeks, stromal infiltration and hypopyon increased. (C) After 6 months of antifungal treatment, corneal lesions regressed.

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  Figure 3. Case 3. (A) At the initial visit, slit lamp photograph showed corneal edema with grographic ulcer and linear hypopyon in the left eye. (B) After 1 month, epithelial defect, stromal infiltration and hypopyon increased. (C). After 3 months, the corneal lesions regressed completely.

Reference

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