P219 Fungal keratitis caused by Pseudallescheria boydii: Clinical and mycological characteristics

Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Pseudallescheria boydii keratitis is rare but important type of fungal keratitis because of the inherently resistance of the organism to many existing antifungal agents. We present the clinical characteristics, risk factors, treatment, and prognosis of patients with P. boydii keratitis, and also present the antifungal sensitivities of the isolated strain. Methods Slit-lamp and confocal microscopy were used for clinical examinations. Fungal isolates were identified based on morphological characteristics and DNA sequence of the internal transcribed spacer region (ITS). In vitro antifungal susceptibility testing for fungal isolates was performed according to the Clinical and Laboratory Standards Institute (CLSI). Results Pseudallescheria boydii was identified in four patients. All patients had a history of ocular trauma. In clinical examination hypopyon was seen in three patients. The main antifungal medications were oral and topical voriconazole. After treatment the visual activity of all patients improved in 2-3 weeks. Conclusion These patients bold the importance of determining causative organism of fungal keratitis and their antibiotic susceptibility. Culture findings are limited in identifying organisms. Sequencing of polymerase chain reaction-amplified DNA is good for accurate and rapid identification of species that can be helpful for optimizing treatment.