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An Outbreak of Fusarium Keratitis Associated With Contact Lens Use in the Northeastern United States

Gorscak, Jason J MD*; Ayres, Brandon D MD; Bhagat, Neelakshi MD*; Hammersmith, Kristin M MD; Rapuano, Christopher J MD; Cohen, Elisabeth J MD; Burday, Michele PhD; Mirani, Neena MD; Jungkind, Donald PhD§; Chu, David S MD*

doi: 10.1097/ICO.0b013e318142b932
Clinical Science

Purpose: To report an outbreak of Fusarium keratitis in contact lens (CL) wearers in the northeastern United States.

Methods: Over a 41-month period, all cases with culture-proven corneal ulceration secondary to Fusarium at 2 tertiary care eye centers were identified through the microbiology departments of each institution, and a retrospective review of charts was performed. Statistical analyses were performed to evaluate a possible association of Fusarium keratitis with specific CL and CL solution brands.

Results: Fifteen cases of Fusarium keratitis were reported at the 2 tertiary centers between July 2005 and May 2006 (16.4 cases/yr) compared with 6 cases over the previous 30 months from January 2003 to June 2005 (2.4 cases/yr). All 15 of the more recent cases were CL users, and none had a history of trauma. All 15 patients claimed use of ReNu brand contact lens solution when they developed keratitis. Twelve (80.0%) of 15 patients were Acuvue soft contact lens users. Ten (66.7%) of 15 patients used tap water to rinse their contact lens cases. Six (40.0%) of 15 cases have thus far required corneal transplantation.

Conclusions: The incidence of corneal ulceration secondary to Fusarium has increased sevenfold over the reported 11-month period at 2 tertiary eye care centers in the northeastern United States compared with the previous 30 months. There seems to be an association between the recent outbreak of Fusarium keratitis among CL users and the use of ReNu contact lens solution. Medical treatment of Fusarium keratitis may be ineffective, and emergent penetrating keratoplasty (PKP) may be required in some patients. CL users and their physicians should reconsider the risks of CL use and discuss proper lens care techniques.

From the *Institute of Ophthalmology and Visual Science, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ; †Corneal Service, Wills Eye Hospital, Thomas Jefferson College, Thomas Jefferson University, Philadelphia, PA; ‡Pathology and Laboratory Medicine, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ; and §Department of Pathology, Thomas Jefferson University, Philadelphia, PA.

Received for publication January 9, 2007; revision received June 1, 2007; accepted June 12, 2007.

Supported in part by an unrestricted grant from Research to Prevent Blindness.

Reprints: David Chu, Doctors Office Center, 90 Bergen St., Suite 6100, Newark, NJ 07101 (e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.