Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture
Purpose: To describe late-onset fungal keratitis after Descemet's stripping endothelial keratoplasty (DSEK) with positive fungal culture of the donor corneal rim. Observations: A case report of a patient undergoing DSEK is described whereby the donor corneal rim culture grew fungus. No infectio...
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2020-06-01
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doaj-46770cb5477b4e1c8d196c7050aab10b2020-11-25T02:37:13ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-06-0118Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal cultureKenneth A. Beckman0Mark S. Milner1Parag A. Majmudar2Jodi I. Luchs3Comprehensive EyeCare of Central Ohio, 450 Alkyre Run Dr #100, Westerville, OH, 43082, United States; The Ohio State University, Havener Eye Institute, 915 Olentangy River Road, Columbus, OH, 43212, United States; Corresponding author. 450 Alkyre Run Dr. #100, Westerville, OH, 43082, United States.The Eye Center of Southern Connecticut, 2880 Old Dixwell Ave., Hamden, CT 06518, United States; Yale University School of Medicine, Department of Ophthalmology, 333 Cedar St., New Haven, CT, 06510, United StatesRush University Medical Center, 1725 W. Harrison Street, Suite 928, Chicago, IL, 60612, United StatesDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, United States; South Shore Eye Care, 2185 Wantagh Ave., Wantagh, NY, 11793, United StatesPurpose: To describe late-onset fungal keratitis after Descemet's stripping endothelial keratoplasty (DSEK) with positive fungal culture of the donor corneal rim. Observations: A case report of a patient undergoing DSEK is described whereby the donor corneal rim culture grew fungus. No infection was initially noted, but the patient developed fungal keratitis 1 year after the original DSEK procedure, despite prophylactic treatment at the time of the positive donor culture. The patient responded to antifungal therapy, but fungal keratitis recurred following completion of a 1-year course of antifungal treatment. The patient eventually underwent full thickness keratoplasty. Conclusions and importance: A positive fungal culture of the donor rim tissue at the time of endothelial keratoplasty is a risk factor for fungal keratitis. Even with prophylactic antifungal treatment, fungal keratitis may eventually develop as late as 1 year after the initial endothelial keratoplasty procedure. Treatment may need to be aggressive, but keratitis may recur despite resolution with antifungal treatment.http://www.sciencedirect.com/science/article/pii/S2451993618305528Fungal keratitisEndothelial keratoplastyDonor contaminationDonor culture |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kenneth A. Beckman Mark S. Milner Parag A. Majmudar Jodi I. Luchs |
spellingShingle |
Kenneth A. Beckman Mark S. Milner Parag A. Majmudar Jodi I. Luchs Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture American Journal of Ophthalmology Case Reports Fungal keratitis Endothelial keratoplasty Donor contamination Donor culture |
author_facet |
Kenneth A. Beckman Mark S. Milner Parag A. Majmudar Jodi I. Luchs |
author_sort |
Kenneth A. Beckman |
title |
Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture |
title_short |
Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture |
title_full |
Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture |
title_fullStr |
Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture |
title_full_unstemmed |
Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture |
title_sort |
late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture |
publisher |
Elsevier |
series |
American Journal of Ophthalmology Case Reports |
issn |
2451-9936 |
publishDate |
2020-06-01 |
description |
Purpose: To describe late-onset fungal keratitis after Descemet's stripping endothelial keratoplasty (DSEK) with positive fungal culture of the donor corneal rim. Observations: A case report of a patient undergoing DSEK is described whereby the donor corneal rim culture grew fungus. No infection was initially noted, but the patient developed fungal keratitis 1 year after the original DSEK procedure, despite prophylactic treatment at the time of the positive donor culture. The patient responded to antifungal therapy, but fungal keratitis recurred following completion of a 1-year course of antifungal treatment. The patient eventually underwent full thickness keratoplasty. Conclusions and importance: A positive fungal culture of the donor rim tissue at the time of endothelial keratoplasty is a risk factor for fungal keratitis. Even with prophylactic antifungal treatment, fungal keratitis may eventually develop as late as 1 year after the initial endothelial keratoplasty procedure. Treatment may need to be aggressive, but keratitis may recur despite resolution with antifungal treatment. |
topic |
Fungal keratitis Endothelial keratoplasty Donor contamination Donor culture |
url |
http://www.sciencedirect.com/science/article/pii/S2451993618305528 |
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