Dr.Tashrifa Naznin

Dr.Tapan Gogoi, Dr.Rajiv Kumar Das

Abstract

A 50year old male presented with Redness, diminision of vision and pain in left eye following trauma with a twig 1 week ago. On slit lamp examination there is stain postive corneal ulcer of size 4*6mm feathery margin dry looking with hypopyon. Ciliary and conjunctival congestion present. Vision was handmovement close to face. Patient was known case of hyperthyroid with bilateral proptosis and was on carbemazole for the same. Intially edarop moxifloxacin 2hrly, natamycin 1hrly topin TDS with CMC was started. After 3 days culture report shows fungal colonies of paecilomyces variotii. The ulcer was atypical and did not show improvement with initial treatment following which intrastromal and intracameral voriconazole was given and oral posaconazole 600mg daily was added. Reduction in size of ulcer was noted. Paecilomyces variotii is a rare fungus which causes oppurtunistic mycoses in immunocompromised hosts. It causes refractory corneal ulcer despite intensive antifungal therapy.