Fusarium keratitis and endophthalmitis treated by intravenous Ambisome

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Abstract

Purpose: This is a case study of Fusarium keratitis progressing to endophthalmitis that was successfully treated with a liposomal formulation of amphotericin B (AmBisome) and local natamycin 5%. Methods: A 41-year-old man presented with a clinical picture of endophthalmitis following deep Fusarium solani keratitis. Treatment with natamycin 5% drops and intravenous amphotericin B 150 mg per day caused renal failure and did not alleviate the endophthalmitis. Therefore, intravenous amphotericin B was replaced with intravenous AmBisome, 300 mg per day, to a cumulative dosage of 5.4 g. Results: Both the endophthalmitis and keratitis were alleviated within several weeks after starting AmBisome treatment. No systemic toxicity was noted. The final ophthalmologic examination showed a paracentral corneal scar, and a satisfactory best corrected visual acuity of 20/40. Conclusions: Owing to their relatively low systemic toxicity, liposomal formulations of amphotericin B can be administered in higher doses than traditional unencapsulated intravenous amphotericin B achieving higher concentrations in the target organ.

Original languageEnglish
Pages (from-to)28-29
Number of pages2
JournalHarefuah
Volume148
Issue number1
StatePublished - Jan 2009

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