The Use of Voriconazole in the Management of Post-Penetrating Keratoplasty Paecilomyces Keratitis

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Abstract
Purpose: The aim of this study was to report successful treatment of Paecilomyces lilacinus keratitis with voriconazole. Method: Case series. Results: Two patients with history of penetrating keratoplasty (PKP) presented with progressive P. lilacinus keratitis. Initial medical treatment failed to control the infection. The first patient received topical voriconazole at the early stage of infection. The second patient required therapeutic PKP and intracameral voriconazole was given at the end of the surgery. He developed presumed secondary endophthalmitis and was treated aggressively with intravitreal and systemic voriconazole. Both the patients responded well to the treatment and achieved complete recovery. Conclusions: These cases illustrated effectiveness and safety of various modes of voriconazole administration in treating P. lilacinus ocular infection.

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