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CASE REPORT
Year : 2014  |  Volume : 16  |  Issue : 1  |  Page : 32-34

Case study of aspergillus flavus causing unilateral acute progressing corneal melt


1 Department of Ophthalmology, Jagadguru Sri Shivarathreeswara Medical College and Hospital, Mysore, Karnataka, India
2 Department of Microbiology, Jagadguru Sri Shivarathreeswara Medical College and Hospital, Mysore, Karnataka, India
3 Department of Post Graduate in Ophthalmology, Jagadguru Sri Shivarathreeswara Medical College and Hospital, Mysore, Karnataka, India

Correspondence Address:
S. K. Prabhakar
Department of Ophthalmology, Jagadguru Sri Shivarathreeswara Medical College and Hospital, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-1282.134463

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Twenty-eight-year-old female patient, reported with history of acute painful loss of vision, following contact with Parthenium plants 15 days ago. Slit lamp examination showed 4-5 mm circumscribed thick plaque of slough in the central cornea with satellite infiltration and tenacious hypopyon. Ten percent potassium hydroxide (KOH) preparation of the slough revealed plenty of septate fungal hyphae. Topical Natamycin was instilled with no improvement. Ulcer debridement was done and thick plaque was subjected to microbiological examination. Fungal culture yielded Aspergillus flavus. Topical Amphotericin B was added along with Natamycin. Despite good response the condition progressed to quick melting and perforation. Crystalline lens extruded through the perforation, after several bouts of sneezing. Perforation was managed by therapeutic corneal grafting. Drug resistance, drug toxicity, corneal thinning and the strain by the patient might explain the disease progression. Factors causing corneal melt and the measures adopted to prevent the intraocular spread are presented.


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