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Keratitis Resulting From Thielavia subthermophila Mouchacca

Theoulakis, Panagiotis MD; Goldblum, David MD; Zimmerli, Stefan MD; Muehlethaler, Konrad MD; Frueh, Beatrice E MD

doi: 10.1097/ICO.0b013e31819717f4
Case Report

Purpose: The purpose of this study was to report the first case of fungal keratitis resulting from Thielavia sp.

Methods: We conducted a retrospective chart review.

Results: A 10-year old girl presented 2 weeks after ocular plant injury with pain and corneal stromal infiltration with central ulceration and ill-defined margins. Cultures of corneal scrapings and biopsy sequence analysis of the ribosomal internal transcribed spacer region isolated Thielavia subthermophila Mouchacca. Clinically, the organism appeared to respond to topical amphotericin B and oral voriconazole. Best-corrected visual acuity at last follow-up visit counted 0.5.

Conclusions: A rare case of Thielavia sp. keratitis was successfully treated with topical amphotericin B and oral voriconazole. Newly developed molecular diagnostic tools contribute to the recognition of a widening spectrum of emerging fungal pathogens capable of causing serious ocular infections.

From *Klinik und Poliklinik für Augenheilkunde, University of Bern, Inselspital, Bern, Switzerland; †Augenklinik, University of Basel, University Hospital Basel, Basel, Switzerland; ‡Institute for Infectious Diseases, University of Bern, Bern, Switzerland; and §Institute for Infectious Diseases, Clinical Microbiology, University of Bern, Bern, Switzerland.

Received for publication July 1, 2008; revision received October 24, 2008; accepted November 28, 2008.

The authors state that they have no proprietary interest in the products named in this article.

Reprints: P. Theoulakis, MD, University Eye Clinic, Inselspital, University of Bern, CH-3010 Bern, Switzerland (e-mail: ptheoulakis@gmail.com).

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