Successful treatment of Paecilomyces lilacinus keratitis with oral posaconazole.

The ubiquitous saprophytic filamentous fungus Paecilomyces lilacinus is a rare cause of fungal keratitis and endophthalmitis and occurs more commonly in patients with predisposing factors such as contact lens wear.1 Paecilomyces keratitis can be devastating due to its poor response to conventional antifungal therapy, often requiring therapeutic penetrating keratoplasty (PKP).1-4 Herein, we describe successful treatment of refractory keratitis caused by Paecilomyces lilacinus with the use of oral posaconazole, a relatively new, generally well-tolerated, and highly potent triazole.