Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%)
Fungal keratitis is a common disease in certain parts of the world and affects several species, including equids, camelids, and homo sapiens, leading to blindness or loss of the eye if the infection is not adequately controlled. Reports of clinical use of antifungals caspofungin and terbinafine are...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-03-01
|
| Series: | Frontiers in Veterinary Science |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fvets.2021.644074/full |
| _version_ | 1818437311650594816 |
|---|---|
| author | Braidee C. Foote Joe S. Smith Anna Catherine Bowden Rachel A. Allbaugh Lionel Sebbag Lionel Sebbag |
| author_facet | Braidee C. Foote Joe S. Smith Anna Catherine Bowden Rachel A. Allbaugh Lionel Sebbag Lionel Sebbag |
| author_sort | Braidee C. Foote |
| collection | DOAJ |
| description | Fungal keratitis is a common disease in certain parts of the world and affects several species, including equids, camelids, and homo sapiens, leading to blindness or loss of the eye if the infection is not adequately controlled. Reports of clinical use of antifungals caspofungin and terbinafine are limited across both veterinary and human medical literature. The alpaca presented in this case demonstrates that deep keratomycosis can be caused by Scopulariopsis brevicaulis and Fusarium verticillioides, two previously unreported fungi to cause keratomycosis in camelids. This report demonstrates successful management with a combination of surgery and topical ophthalmic treatment with caspofungin 0.5% solution and terbinafine 1% dermatologic cream, after initially failing treatment with topical voriconazole 1% solution. Combination therapy appears more effective than monotherapy with some fungal organisms, and synergy between antifungal agents is thought to play a role in the success of combination therapy. Surgery to remove the bulk of the fungal infection is especially helpful in cases that fail initial medical therapy. |
| first_indexed | 2024-12-14T17:22:40Z |
| format | Article |
| id | doaj.art-b01313a0c6bb4939b8c7d6e3ce103670 |
| institution | Directory Open Access Journal |
| issn | 2297-1769 |
| language | English |
| last_indexed | 2024-12-14T17:22:40Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Veterinary Science |
| spelling | doaj.art-b01313a0c6bb4939b8c7d6e3ce1036702022-12-21T22:53:18ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692021-03-01810.3389/fvets.2021.644074644074Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%)Braidee C. Foote0Joe S. Smith1Anna Catherine Bowden2Rachel A. Allbaugh3Lionel Sebbag4Lionel Sebbag5Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United StatesDepartment of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United StatesDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United StatesDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United StatesDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United StatesKoret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, IsraelFungal keratitis is a common disease in certain parts of the world and affects several species, including equids, camelids, and homo sapiens, leading to blindness or loss of the eye if the infection is not adequately controlled. Reports of clinical use of antifungals caspofungin and terbinafine are limited across both veterinary and human medical literature. The alpaca presented in this case demonstrates that deep keratomycosis can be caused by Scopulariopsis brevicaulis and Fusarium verticillioides, two previously unreported fungi to cause keratomycosis in camelids. This report demonstrates successful management with a combination of surgery and topical ophthalmic treatment with caspofungin 0.5% solution and terbinafine 1% dermatologic cream, after initially failing treatment with topical voriconazole 1% solution. Combination therapy appears more effective than monotherapy with some fungal organisms, and synergy between antifungal agents is thought to play a role in the success of combination therapy. Surgery to remove the bulk of the fungal infection is especially helpful in cases that fail initial medical therapy.https://www.frontiersin.org/articles/10.3389/fvets.2021.644074/fullcamelid ophthalmologyScopulariopsis brevicaulisFusarium verticillioidescorneal abscesscorneal crosslinkingkeratomalacia |
| spellingShingle | Braidee C. Foote Joe S. Smith Anna Catherine Bowden Rachel A. Allbaugh Lionel Sebbag Lionel Sebbag Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%) Frontiers in Veterinary Science camelid ophthalmology Scopulariopsis brevicaulis Fusarium verticillioides corneal abscess corneal crosslinking keratomalacia |
| title | Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%) |
| title_full | Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%) |
| title_fullStr | Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%) |
| title_full_unstemmed | Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%) |
| title_short | Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%) |
| title_sort | case report successful management of refractory keratomycosis in an alpaca using penetrating keratoplasty and combination antifungal therapy caspofungin 0 5 and terbinafine 1 |
| topic | camelid ophthalmology Scopulariopsis brevicaulis Fusarium verticillioides corneal abscess corneal crosslinking keratomalacia |
| url | https://www.frontiersin.org/articles/10.3389/fvets.2021.644074/full |
| work_keys_str_mv | AT braideecfoote casereportsuccessfulmanagementofrefractorykeratomycosisinanalpacausingpenetratingkeratoplastyandcombinationantifungaltherapycaspofungin05andterbinafine1 AT joessmith casereportsuccessfulmanagementofrefractorykeratomycosisinanalpacausingpenetratingkeratoplastyandcombinationantifungaltherapycaspofungin05andterbinafine1 AT annacatherinebowden casereportsuccessfulmanagementofrefractorykeratomycosisinanalpacausingpenetratingkeratoplastyandcombinationantifungaltherapycaspofungin05andterbinafine1 AT rachelaallbaugh casereportsuccessfulmanagementofrefractorykeratomycosisinanalpacausingpenetratingkeratoplastyandcombinationantifungaltherapycaspofungin05andterbinafine1 AT lionelsebbag casereportsuccessfulmanagementofrefractorykeratomycosisinanalpacausingpenetratingkeratoplastyandcombinationantifungaltherapycaspofungin05andterbinafine1 AT lionelsebbag casereportsuccessfulmanagementofrefractorykeratomycosisinanalpacausingpenetratingkeratoplastyandcombinationantifungaltherapycaspofungin05andterbinafine1 |