PMC3392915_01
Case 1. (A) The round, central corneal infiltrate with feathery margins is surrounded by a severely edematous cornea. (B) Enlargement of the infiltrate at 2.5 weeks after discontinuing corticosteroids and starting antifungal agents. (C) Colony of Paecilomyces lilacinus isolated from cornea, and the color of colony in 14 days is lilac on potato dextrose agar. (D) Photomicrograph of P. lilacinus demonstrating the long conidiophores arising from hyphae, tapering phialides, and chains of conidia (lactophenol cotton blue stain). (E) Two weeks after starting treatment with voriconazole, the infiltrate has decreased in size. (F) Two years after the discharge, the cornea is clear and no recurrence of fungal infection has been reported.
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Slit-lamp examination showed a round central corneal infiltrate with feathery margins (Figure 1A). One week later, after starting voriconazole, the infiltrate worsened (Figure 1B), and P. lilacinus was isolated from the corneal culture (Figure 1C and D). One week later, the infiltrate diminished (Figure 1E). His VA at the last visit was 0.1 (Figure 1F).
PMC3392915_02
Case 2. (A) Nasal scleral hyperemia and nasal peripheral corneal infiltrate with feathery margins. (B) Enlargement of the corneal infiltrate 2 days after discontinuing treatment with corticosteroids and starting antifungal agents. (C) Even though voriconazole decreased the size of the corneal infiltrate, the peripheral cornea is perforated. A fibrous clot was found in the anterior chamber. (D) One year after the discharge, the cornea is clear, and no recurrence of fungal infection has been reported.
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Slit- lamp examination showed nasal scleral hyperemia and a nasal peripheral corneal infiltrate with feathery margins ( Figure 2A). Two days later, hypopyon appeared (Figure 2B), and P. lilacinus was isolated from the corneal culture. Two weeks later, the infiltrate had improved, but the cornea was perforated (Figure 2C). His VA at the last visit was 0.2 (Figure 2D).
PMC3392915_03
Case 3. (A) Perforation of the cornea 1 day after presentation at our hospital. (B) Eight months after surgery, the nasal cornea was clear, and the patient's visual acuity was 0.8.
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The next day, the cornea was perforated (Figure 3A), and lamellar keratoplasty was performed. Her VA at the last visit was 0.8 (Figure 3B).
PMC3392915_04
Case 4. (A) An upper peripheral corneal infiltrate with feathery margins. (B) Three months after starting treatment with antifungal agents, the cornea was clear, and the patient's visual acuity was 1.0.
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Slit-lamp examination showed an upper peripheral corneal infiltrate with feathery margins (Figure 4A). His VA at the last visit was 1.0 (Figure 4B).