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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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OBJECTIF: Décrire le premier cas de kératite post-traumatique à Scedosporium apiospermum (ScA) traitée avec le voriconazole systémique et topique.

RÉSUMÉ DU CAS: Un homme de 19 ans a été admis à l'hôpital pour une lésion traumatique à l'oeil gauche avec section complète de la cornée survenue suite à l'utilisation d'un couteau de jardinage. Après avoir reçu initialement un traitement empirique, le patient a finalement été traité avec du voriconazole systémique et topique et n'a pas eu à subir d'énucléation. Cinq mois après le traumatisme, une kératoplastie avec implantation d'une lentille intra-oculaire a été réalisée et a permis une récupération satisfaisante de la vision.

DISCUSSION: La kératite à ScA est rare mais doit être suspectée lorsqu'un traumatisme oculaire avec un objet contaminé survient. Parmi les différents antifongiques disponibles, le voriconazole possède certains avantages tels qu'une concentration minimale inhibitrice plus faible et la disponibilité d'une forme orale.

CONCLUSIONS: Le voriconazole semble prometteur comme solution de rechange aux antifongiques conventionnels dans le traitement de la kératite à ScA. Il est disponible sous formes orale et intraveineuse, ce qui constitue un avantage important pour le traitement de cette infection.

www.theannals.com, DOI 10.1345/aph.1D128


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