{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T01:08:20Z","timestamp":1775351300954,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,4,1]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>We report a case of a 41-year-old woman, wearer of contact lenses who was presented to the emergency room with a 2-month history of pain and red eye. She presented with a severe keratitis refractory to quinolones, fortified antibiotics and clotrimazole. Due to the risk of perforation, a tectonic penetrating keratoplasty (PK) was performed. Clinical signs of keratitis recurrence were observed and cultures were positive for <jats:italic>Purpureocillium lilacinum (<\/jats:italic>former <jats:italic>Paecilomyces lilacinus)<\/jats:italic>. The patient did not improve on topical amphotericin B and intracameral voriconazole. Worsening of clinical condition required a new PK. Oral posaconazole was initiated postoperatively and suspended at the fourth postoperative month. The cornea remains clear until the last follow-up visit, 12 months after the second graft. To our knowledge, this is the second case report that documents the effectiveness of oral posaconazole in a refractory <jats:italic>P. lilacinus<\/jats:italic> keratitis, resistant to other second-generation triazoles and conventional antifungals.<\/jats:p>","DOI":"10.1136\/bcr-2018-228645","type":"journal-article","created":{"date-parts":[[2019,4,11]],"date-time":"2019-04-11T14:27:30Z","timestamp":1554992850000},"page":"e228645","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Posaconazole in the treatment of refractory <i>Purpureocillium lilacinum<\/i> (former <i>Paecilomyces lilacinus<\/i>) keratitis: the salvation when nothing works"],"prefix":"10.1136","volume":"12","author":[{"given":"Mariana","family":"Almeida Oliveira","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, 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