| 본문 : Purpose: To report a case of Candida orthopsilosis-infected keratitis patient who had been treated with caspofungin.
Case summary: A 61-year-old woman with a past history of vitrectomy for proliferative diabetic retinopathy was referred to as an address for pain, congestion and corneal opacity in the right eye. The patient had previously been using autologous serum eye drops for corneal abrasion, which repeated occasional improvement and deterioration. On slit lamp examination, 1.5x1.7 mm sized corneal epi-defect with infiltration and hypopyon were noted. Then we conducted the culture test, and Candida orthopsilosis was identified. We started to treat with topical moxifloxacin and voriconazole eyedrops empirically. In the first two weeks of treatment, hypopyon, corneal epi-defect with infiltration were improved, but were then maintained without much improvement. Then we conducted an antibiotic sensitivity test, and we found that the strains are highly sensitive to caspofungin. And we changed voriconazole eyedrops to caspofungin eyedrops as a treatment. After 1 week of treatment of caspofungin eyedrops, the corneal lesion with infiltration was dramatically resolved, and it completely improved 2 months later, remaining mild corneal opacity.
Conclusions: Through this case, we experienced a case of fungal keratitis caused by Candida orthopsilosis, which has not yet been reported in South Korea, and we have confirmed that caspofungin can be considered as a new treatment option in the voriconazole-resistant fungal keratitis. |