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Recalcitrant Paecilomyces keratitis
  1. Seetha Lakshmi and
  2. Cristina Vanessa Garcia
  1. Department of Infectious Disease, University of South Florida, Tampa, Florida, USA
  1. Correspondence to Dr. Seetha Lakshmi, seetha{at}


A 54-year-old Caucasian woman presented with corneal ulcer of the right eye of 4 weeks duration after scratching her cornea while removing her contact lens and artificial eye lashes. Her visual acuity was 20/32 (left eye) and finger counting (right eye). She had a 3x3 mm epithelial defect with underlying corneal oedema and hypopyon. Right eye cultures grew Paecilomyces species. Topical and systemic antifungal agents were initiated. Due to the sight-threatening disease, the patient underwent surgical intervention with intrastromal injection of amphotericin B and a large conjunctival flap covering 75% of the right eye corneal ulcer. After 3 months of therapy, she had near-complete resolution of the corneal ulcer. Unfortunately, recurrence of the corneal ulcer occurred within 3 weeks of cessation of therapy, prompting reinitiation of ophthalmic and systemic antifungal agents. The patient was advised to continue therapy for 6 months with regular follow-up.

  • infectious diseases
  • ophthalmology

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  • Contributors Both SL and CVG treated the patient, wrote the content of the case and performed the final edits.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.