Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture.

ABSTRACT:

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.

SUBMITTER: Beckman KA 

PROVIDER: S-EPMC7184523 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature