Necrotizing scleritis due to Hormographiella aspergillata.

Abstract

PURPOSE:

To report the management and outcome of a case of necrotizing scleritis due to Hormographiella aspergillata.

METHODS:

Case report.

RESULTS:

A 79-year-old woman developed scleral inflammation following accidental trauma with a gorse plant in her left eye. An abscess formed at the site of the injury, which was surgically drained. Filamentous fungi were identified from the abscess contents, and oral voriconazole and topical voriconazole and natamycin drops were prescribed. Phenotypic analysis confirmed the presence of Hormographiella aspergillata, with low minimum inhibitory concentrations (MIC) for voriconazole and amphotericin B. Two weeks later the patient presented with an area of necrotizing scleritis which required surgical debridement and scleral grafting. Three months later, the scleral inflammation had resolved leaving an area of scleromalacia.

CONCLUSIONS:

Hormographiella aspergillata is a common environmental fungus that has recently emerged as a human pathogen and a rare cause of scleritis. To the best of our knowledge, this is the first report of scleritis in which a pure culture of H. aspergillata was obtained. Successful management poses a challenge as there are limited reports on antifungal susceptibility and a combination of medical and surgical treatment is often required.

• Authors: David Lamas-Francis, Jose Llovo-Taboada, Daniel Navarro, Rosario Touriño, Teresa Rodríguez-Ares
• Journal: European journal of ophthalmology (Eur J Ophthalmol) Vol. 33 Issue 5 Pg. NP71-NP74 (Sep 2023) ISSN: 1724-6016 [Electronic] United States
• PMID: 35915985 (Publication Type: Case Reports, Journal Article)

Chemical References

• Voriconazole
• Antifungal Agents

Topics

• Humans
• Female
• Aged
• Scleritis (diagnosis, drug therapy, etiology)
• Voriconazole (therapeutic use)
• Abscess (drug therapy)
• Antifungal Agents (therapeutic use)