Uso de voriconazol tópico en queratitis por alternaria

espanolCaso clinico: Hombre de 38 anos remitido de otro centro por presentar queratitis fungica por Alternaria 25 dias despues de realizarle una queratoplastia penetrante postraumatica en ojo derecho. Se instaura tratamiento con voriconazol topico y oral con buena evolucion posterior. Discusion: Las queratitis fungicas por Alternaria son poco frecuentes. Su tratamiento es dificil porque la evolucion clinica no se correlaciona con la susceptibilidad in vitro del hongo. Producen cuadros clinicos que requieren un rapido diagnostico y tratamiento, para evitar la perdida de vision. La combinacion de voriconazol topico y sistemico puede ser una buena alternativa en caso de hongos resistentes al tratamiento convencional. EnglishClinical case: A 38-year-old man with fungal Alternaria keratitis was referred from another hospital 25 days after post-traumatic penetrating keratoplastia surgery on his right eye. We commenced treatment with topical voriconazole and the condition resolved. Discussion: Fungal Alternaria keratitis is rare, and treatment is difficult because the clinical response does not correlate well with the antibiotic in vitro sensitivity of the fungus. Clinical cases need to be diagnosed and treated quickly if visual loss is to be avoided. The combination of topical and systemic voriconazole has been shown to be an effective treatment for this condition