Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report
Abstract Background To report a case of lenticular infection caused by Aspergillus, which was diagnosed 13 weeks after traumatic corneal laceration. Case presentation A 60-year-old woman presented with traumatic corneal laceration including anterior lens capsule rupture and traumatic cataract after...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-020-01441-w |
| _version_ | 1818600252632989696 |
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| author | Hyun Ji Hwang Yong Woo Lee Kyung Min Koh Kyu Yeon Hwang Young A Kwon Sang Wroul Song Byoung Yeop Kim Kook Young Kim |
| author_facet | Hyun Ji Hwang Yong Woo Lee Kyung Min Koh Kyu Yeon Hwang Young A Kwon Sang Wroul Song Byoung Yeop Kim Kook Young Kim |
| author_sort | Hyun Ji Hwang |
| collection | DOAJ |
| description | Abstract Background To report a case of lenticular infection caused by Aspergillus, which was diagnosed 13 weeks after traumatic corneal laceration. Case presentation A 60-year-old woman presented with traumatic corneal laceration including anterior lens capsule rupture and traumatic cataract after being hit with a chestnut in the right eye. There were multiple injuries due to tiny thorns of the chestnut, including the conjunctiva, sclera, cornea, and anterior lens capsule. But no visible foreign body was detected by slit-lamp examination. Topical corticosteroid was prescribed to resolve the conjunctival inflammation induced by the thorns of chestnut, which could have caused persistent irritation. As conjunctival injection and edema being decreased during outpatient clinical follow-up, embedded conjunctival foreign body was detected and surgically removed (1st surgery). Approximately 10 weeks after the trauma, severe inflammation of the anterior segment accompanied with hypopyon developed suddenly and at the same time embedded scleral foreign body was revealed. After removal of scleral foreign body (2nd surgery), unspecified mold species was cultured from the scleral foreign body in SDA (Sabouraud dextrose agar) plate. Suspicious corneal foreign body was removed as 3rd surgery and phacoemulsification of traumatic cataract was planned as 4th surgery. Aspergillus was finally detected from removed anterior capsule and fibrotic membrane during the operation. Fungal infection resolved successfully after administration of topical (1% voriconazole and 5% natamycin) and systemic (fluconazole) antifungal agents and phacoemulsification of traumatic cataract. Conclusion Chestnut thorns can damage multiple ocular tissues simultaneously. Lens capsular rupture could result in fungal inoculation and lead to delayed lenticular fungal infection with complicated cataract formation. In cases of ocular trauma due to organic substances such as thorns and branches, the possibility of fungal infection should be considered. |
| first_indexed | 2024-12-16T12:32:32Z |
| format | Article |
| id | doaj.art-decbd1030d144fd5b52b6042df142743 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-16T12:32:32Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-decbd1030d144fd5b52b6042df1427432022-12-21T22:31:40ZengBMCBMC Ophthalmology1471-24152020-05-012011610.1186/s12886-020-01441-wLenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case reportHyun Ji Hwang0Yong Woo Lee1Kyung Min Koh2Kyu Yeon Hwang3Young A Kwon4Sang Wroul Song5Byoung Yeop Kim6Kook Young Kim7Department of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineDepartment of Cornea and Refractive Surgery, Kim’s Eye Hospital, Myunggok Eye Research Institute, Konyang University College of MedicineAbstract Background To report a case of lenticular infection caused by Aspergillus, which was diagnosed 13 weeks after traumatic corneal laceration. Case presentation A 60-year-old woman presented with traumatic corneal laceration including anterior lens capsule rupture and traumatic cataract after being hit with a chestnut in the right eye. There were multiple injuries due to tiny thorns of the chestnut, including the conjunctiva, sclera, cornea, and anterior lens capsule. But no visible foreign body was detected by slit-lamp examination. Topical corticosteroid was prescribed to resolve the conjunctival inflammation induced by the thorns of chestnut, which could have caused persistent irritation. As conjunctival injection and edema being decreased during outpatient clinical follow-up, embedded conjunctival foreign body was detected and surgically removed (1st surgery). Approximately 10 weeks after the trauma, severe inflammation of the anterior segment accompanied with hypopyon developed suddenly and at the same time embedded scleral foreign body was revealed. After removal of scleral foreign body (2nd surgery), unspecified mold species was cultured from the scleral foreign body in SDA (Sabouraud dextrose agar) plate. Suspicious corneal foreign body was removed as 3rd surgery and phacoemulsification of traumatic cataract was planned as 4th surgery. Aspergillus was finally detected from removed anterior capsule and fibrotic membrane during the operation. Fungal infection resolved successfully after administration of topical (1% voriconazole and 5% natamycin) and systemic (fluconazole) antifungal agents and phacoemulsification of traumatic cataract. Conclusion Chestnut thorns can damage multiple ocular tissues simultaneously. Lens capsular rupture could result in fungal inoculation and lead to delayed lenticular fungal infection with complicated cataract formation. In cases of ocular trauma due to organic substances such as thorns and branches, the possibility of fungal infection should be considered.http://link.springer.com/article/10.1186/s12886-020-01441-wAspergillosisCorneal lacerationEndophthalmitisFungal infectionIntralenticular abscess |
| spellingShingle | Hyun Ji Hwang Yong Woo Lee Kyung Min Koh Kyu Yeon Hwang Young A Kwon Sang Wroul Song Byoung Yeop Kim Kook Young Kim Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report BMC Ophthalmology Aspergillosis Corneal laceration Endophthalmitis Fungal infection Intralenticular abscess |
| title | Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report |
| title_full | Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report |
| title_fullStr | Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report |
| title_full_unstemmed | Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report |
| title_short | Lenticular fungal infection caused by Aspergillus in a patient with traumatic corneal laceration: a case report |
| title_sort | lenticular fungal infection caused by aspergillus in a patient with traumatic corneal laceration a case report |
| topic | Aspergillosis Corneal laceration Endophthalmitis Fungal infection Intralenticular abscess |
| url | http://link.springer.com/article/10.1186/s12886-020-01441-w |
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