期刊名称：Journal of the Korean Ophthalmological Society
印刷版ISSN：0378-6471
出版年度：2021
卷号：62
期号：1
页码：114-119
DOI：10.3341/jkos.2021.62.1.114
出版社：The Korean Ophthalmological Society
摘要：Purpose We report a case of post-pterygium excisional Pseudallescheria boydii ( P. boydii ) necrotizing scleritis successfully treated with multi-antifungal agents. Case summary A 73-year-old female with a history of pterygium excision 6 years prior was referred to our institute because of worsening scleritis in the left eye during high-dose, 2-week steroid treatment. On the initial visit, an oval ulcer was observed in the temporal sclera adjacent to the limbus. All steroids were stopped and 1% voriconazole, 5% natamycin, 2.5% vancomycin, and 5% ceftazidime eyedrops were applied every hour and oral voriconazole 200 mg prescribed once a day, but the scleral necrosis continued to worsen. On day 10, the filamentous fungus P. boydii was isolated; 0.5% caspofungin eyedrops were added and the topical voriconazole concentration increased to 2%. Six weeks later, despite epithelization over the scleral necrosis, choroidal detachment developed. The antifungal treatment was continued and a dispersive, ophthalmic viscosurgical device inserted in the anterior chamber. At 14 weeks of treatment, the scleral necrosis was completely epithelialized and the choroidal detachment had disappeared. Conclusions When encountering a case of P. boydii -caused necrotizing scleritis developing after pterygium excision surgery, long-term intensive treatment with several antifungal agents must be considered.
