Cylindrocarpon lichenicola keratomycosis in Nigeria: the challenge of limited access to effective antimicrobials

نویسندگان

  • Emmanuel O. Irek
  • Temitope O. Obadare
  • Patrick A. Udonwa
  • Olajumoke Laoye
  • Oyekola V. Abiri
  • Adenike O. Adeoye
  • Aaron O. Aboderin
چکیده

INTRODUCTION We report a rare cause of keratitis, due to Cylindrocarpon lichenicola, in a farmer with keratomycosis. Despite the acknowledged virulence of this fungus, a suitable antifungal for its management was not accessible. CASE PRESENTATION A 67-year-old farmer presented with a two-week history of pain, mucopurulent discharge, redness and a corneal ulcer with a visual acuity of hand movement in the right eye. With a working diagnosis of infective keratitis, corneal scrapings were taken under a slit lamp biomicroscope for microbiological testing. Direct lactophenol cotton blue mounts revealed septate fungal hyphae, while fungal culture on Sabouraud dextrose agar at room temperature grew woolly mould phenotypically consistent with C. lichenicola. MANAGEMENT AND OUTCOME The patient was started on hourly topical natamycin (5%), ciprofloxacin (0.3%), two-hourly instillation of tobramycin (0.3%) and atropine (1%) twice daily for three months following the isolation of the fungus. The eye healed with a corneal scar and no improvements in visual acuity. DISCUSSION This infection was difficult to manage due to the inaccessibility of a suitable antifungal, namely, voriconazole in our setting. Hence, there is a need for prompt identification and early institution of suitable antifungals in any patient with suspected keratomycosis.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Tinea pedis due to Cylindrocarpon lichenicola beginning onycholysis

A 33 year old woman presented with both feet, humid and white Tinea pedis at the second, third and fourth inter-toes areas associated with a beginning onycholysis of the nails lasting for 18 months. KOH mount of the samples was positive for fungal hyphae. The fungus was isolated on Sabouraud-chlorampphenicol agar and identified as Cylindrocarpon lichenicola. The patient was treated with an asso...

متن کامل

Analysis of phylogenetic relationship of Cylindrocarpon lichenicola and Acremonium falciforme to the Fusarium solani species complex and a review of similarities in the spectrum of opportunistic infections caused by these fungi.

An emerging pattern of similarity in medical case reports led to a project to compare the phylogenetic affinities of two well-known tropical fungal opportunistic pathogens, Cylindrocarpon lichenicola and Acremonium falciforme, to members of the Fusarium solani species complex. C. lichenicola and A. falciforme, despite their deviating conidial morphologies, were shown via sequencing of the ribos...

متن کامل

Access to effective antimicrobials: a worldwide challenge.

Recent years have seen substantial improvements in life expectancy and access to antimicrobials, especially in low-income and lower-middle-income countries, but increasing pathogen resistance to antimicrobials threatens to roll back this progress. Resistant organisms in health-care and community settings pose a threat to survival rates from serious infections, including neonatal sepsis and heal...

متن کامل

Barriers of Asian Youth to Access Sexual Reproductive Health Information and Services: A Literature Review

Background Despite recommendations from the World Health Organization in most Asian countries, young people’s sexual and reproductive health (SRH) needs are poorly provided and understood. The aim of this review paper is identifying barriers as well as improving strategies to access SRH information and services among Asian youth. Materials and M...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 6  شماره 

صفحات  -

تاریخ انتشار 2017