Keratitis X Acremonium: A Case Report and Literature Review

Abstract

Purpose: Describe an unusual development of fungal keratitis caused by Acremonium sp in six patients who underwent cataract surgery at an ophthalmology service in Brazil, as well as to report the origin of these infections. Methods: Swabs from the affected corneas were collected to perform culture for bacteria and fungi. These materials were sown in Blood agar (Difco/USA), Macconkey agar (Difco/USA) and Thioglycolate broth (Difco/USA) for bacterial research and Sabouraud agar (Difco/USA) for fungi research. A microbiological study was carried out to analyze surgical instruments, the environment and other materials used in the surgeries. Results: Case reports occurred with six patients, all aged over 71 and 85 years, who underwent a surgical procedure for cataract correction by an Ophthalmology service. After surgery, these patients presented loss of unilateral visual capacity, with the formation of a white mass on the cornea. Swabs from the affected corneas were collected
to perform culture for bacteria and fungi, in specific culture media. The bacterial cultures showed negative results. Fungal cultures revealed the presence of Acremonium spp. Conclusions: It is likely that Acremonium spores found in the wardrobe were deposited on all the sterile material stored there. At the time of cataract surgeries, this material was unpacked and fungal structures became detached and found in the surgical field of these patients’ eyes a gateway. Thus, cleaning and sanitizing measures for surfaces must be implemented and monitored, especially in critical areas such as in hospital areas, in order to avoid damage to patients’ health.

Keywords: Keratitis; Acremonium;Cataract Surgeries; Fungal

 

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