Clinical response of contact lens-associated fungal keratitis to topical fluoroquinolone therapy

Wuqaas M. Munir, Steven I. Rosenfeld, Ira Udell, Darlene Miller, Carol Karp, Eduardo C Alfonso

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

PURPOSE: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or significantly improved without antifungal therapy. METHODS: Observational case report of 5 patients with a history of contact lens wear who presented with infectious keratitis. Two patients had growth of fungal species on corneal microbiologic cultures, and of the remaining 3 patients, 2 showed fungal elements on confocal microscopy. All 5 patients exhibited growth of fungal species on contact lens microbiologic cultures. All patients received topical fluoroquinolone therapy as initial treatment. RESULTS: In 3 cases, of whom 2 were treated with moxifloxacin 0.5%, the keratomycosis resolved completely on topical fluoroquinolone therapy. One case was switched to topical tobramycin 14 mg/mL and cefazolin 50 mg/mL with complete resolution of the infection. The final case showed marked initial improvement on fluoroquinolone therapy but was subsequently treated with natamycin 5%. CONCLUSIONS: Fungal keratitis associated with soft contact lens wear may occasionally present in a less aggressive form. Topical fluoroquinolone therapy may be an adjunct to the innate immune response in eradicating less fulminant keratomycosis.

Original languageEnglish
Pages (from-to)621-624
Number of pages4
JournalCornea
Volume26
Issue number5
DOIs
StatePublished - Jun 1 2007

Fingerprint

Keratitis
Contact Lenses
Fluoroquinolones
Therapeutics
Natamycin
Hydrophilic Contact Lens
Cefazolin
Tobramycin
Growth
Innate Immunity
Confocal Microscopy
Infection

Keywords

  • Contact lens
  • Fluoroquinolone
  • Fungus
  • Keratitis
  • Keratomycosis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Clinical response of contact lens-associated fungal keratitis to topical fluoroquinolone therapy. / Munir, Wuqaas M.; Rosenfeld, Steven I.; Udell, Ira; Miller, Darlene; Karp, Carol; Alfonso, Eduardo C.

In: Cornea, Vol. 26, No. 5, 01.06.2007, p. 621-624.

Research output: Contribution to journalArticle

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abstract = "PURPOSE: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or significantly improved without antifungal therapy. METHODS: Observational case report of 5 patients with a history of contact lens wear who presented with infectious keratitis. Two patients had growth of fungal species on corneal microbiologic cultures, and of the remaining 3 patients, 2 showed fungal elements on confocal microscopy. All 5 patients exhibited growth of fungal species on contact lens microbiologic cultures. All patients received topical fluoroquinolone therapy as initial treatment. RESULTS: In 3 cases, of whom 2 were treated with moxifloxacin 0.5{\%}, the keratomycosis resolved completely on topical fluoroquinolone therapy. One case was switched to topical tobramycin 14 mg/mL and cefazolin 50 mg/mL with complete resolution of the infection. The final case showed marked initial improvement on fluoroquinolone therapy but was subsequently treated with natamycin 5{\%}. CONCLUSIONS: Fungal keratitis associated with soft contact lens wear may occasionally present in a less aggressive form. Topical fluoroquinolone therapy may be an adjunct to the innate immune response in eradicating less fulminant keratomycosis.",
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AB - PURPOSE: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or significantly improved without antifungal therapy. METHODS: Observational case report of 5 patients with a history of contact lens wear who presented with infectious keratitis. Two patients had growth of fungal species on corneal microbiologic cultures, and of the remaining 3 patients, 2 showed fungal elements on confocal microscopy. All 5 patients exhibited growth of fungal species on contact lens microbiologic cultures. All patients received topical fluoroquinolone therapy as initial treatment. RESULTS: In 3 cases, of whom 2 were treated with moxifloxacin 0.5%, the keratomycosis resolved completely on topical fluoroquinolone therapy. One case was switched to topical tobramycin 14 mg/mL and cefazolin 50 mg/mL with complete resolution of the infection. The final case showed marked initial improvement on fluoroquinolone therapy but was subsequently treated with natamycin 5%. CONCLUSIONS: Fungal keratitis associated with soft contact lens wear may occasionally present in a less aggressive form. Topical fluoroquinolone therapy may be an adjunct to the innate immune response in eradicating less fulminant keratomycosis.

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