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Published Online, 30 January 2004, www.theannals.com, DOI 10.1345/aph.1D128.
 The Annals of Pharmacotherapy: Vol. 38, No. 3, pp. 414-417. DOI 10.1345/aph.1D128
© 2004 Harvey Whitney Books Company.
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Voriconazole in Fungal Keratitis Caused by Scedosporium apiospermum

Carmen Hernández Prats, PharmD

Clinical Pharmacist, Pharmacy Department, Alicante University General Hospital, Alicante, Spain

Francisca Llinares Tello, PharmD PhD

Clinical Pharmacist, Pharmacy Department, Alicante University General Hospital

Amparo Burgos San José, PharmD

Clinical Specialist, Pharmacy Department, Alicante University General Hospital

Juan Selva Otaolaurruchi, PharmD PhD

Clinical Specialist, Pharmacy Department, Alicante University General Hospital

Juan Pablo Ordovás Baines, PharmD PhD

Clinical Specialist; Director, Department of Pharmacy, Alicante University General Hospital

Reprints: Carmen Hernández Prats PharmD, Hospital General de Alicante, Servicio de Farmacia, Maestro Alonso n° 109, CP 03010 Alicante, España, fax 965938908, fgtorregrosa{at}terra.es

OBJECTIVE: To describe the first case, to the best of our knowledge, of posttraumatic Scedosporium apiospermum (ScA) keratitis successfully treated with systemic and topical voriconazole.

CASE SUMMARY: A 19-year-old man was admitted to the hospital with an incisive wound of his left eye and the cornea totally sectioned after trauma with a cutter used in gardening. Initial empirical treatment was followed by systemic and topical voriconazole, and the eye did not have to be enucleated. Five months after the trauma, a penetrating keratoplasty and chamber intraocular lens implantation was performed with a favorable visual outcome.

DISCUSSION: ScA keratitis is rare, but it must be suspected if a history of ocular injury with contaminated objects exists. Among the antifungals available to treat ScA keratitis, voriconazole has shown advantages such as the lowest minimum inhibitory concentration and the availability of an oral formulation.

CONCLUSIONS: Voriconazole shows promise as an effective alternative to conventional antifungals in the treatment of ScA keratitis. It is available both as oral and intravenous preparations, which is a great advantage in these lengthy infections.

Key Words: fungal keratitis, Scedosporium apiospermum, voriconazole

Published Online, January 30, 2004. www.theannals.com, DOI 10.1345/aph.1D128


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