Paecilomyces/Purpureocillium keratitis: A consecutive study with a case series and literature review

Yen Ting Chen, Lung Kun Yeh, David H.K. Ma, Hsin Chiung Lin, Chi Chin Sun, Hsin Yuan Tan, Hung Chi Chen, Shin Yi Chen, Pei Lun Sun*, Ching Hsi Hsiao*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations

Abstract

Paecilomyces/Purpureocillium species is an emerging pathogen of fungal keratitis; the risk factor, clinical course, and outcome of Paecilomyces/Purpureocillium keratitis need more exploration. We retrospectively reviewed 12 patients with culture-proven Paecilomyces/Purpureocillium keratitis in our hospital from 2003 to 2017 and combined them with 50 previous cases reported after the review conducted by Yuan et al. in 2009. Clinical features between the previously and newly reported cases were compared using the publication by Yuan et al. as a cutoff point. The mean age of the 62 newly reported patients with Paecilomyces/Purpureocillium keratitis was 52.7 years. Of these, contact lens wear was the most common predisposing factor (n = 32, 52%), followed by a preexisting corneal disease or previous ocular surgery (n = 12, 19%), and trauma (n = 8, 13%). Fifty eyes (81%) were treated with voriconazole, of which 31 (63%) were medically cured. Twenty-one of 62 eyes (34%) required therapeutic surgery. Compared with the 42 patients reported by Yuan et al., the patients were younger (P =. 025); a higher proportion of the patients were contact lens wearers (P =. 005); more patients were treated with voriconazole (P =. 000); fewer patients required therapeutic surgery (P =. 000) in recent reports. Contact lens use has become the major risk factor for Paecilomyces/Purpureocillium keratitis. The surgical rate has been significantly lower in recent publications, probably because of the prevalent use of voriconazole.

Original languageEnglish
Pages (from-to)293-299
Number of pages7
JournalMedical Mycology
Volume58
Issue number3
DOIs
StatePublished - 01 04 2020

Bibliographical note

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.

Keywords

  • Paecilomyces/Purpureocillium
  • keratitis
  • voriconazole

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