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Chrysosporium parvum keratomycosis
M D Wagoner1, I A Badr, A A Hidayat
1Anterior Segment/External Disease Division, King Khaled Eye Specialist Hospital, Kingdom of Saudi Arabia. kkeshres@naseej.com
Purpose:
To report a case of corneal infection with Chrysosporium parvum, a filamentous fungus usually associated with pulmonary infections.
Methods:
A 43-year-old Saudi man had a corneal stromal infiltrate and perforation of his left eye. He was treated with a therapeutic penetrating keratoplasty and topical and systemic antifungal therapy. Corneal scrapings, microbiologic evaluation, and histopathologic examination of the surgical specimen were performed to establish the diagnosis. After the development of recurrent stromal keratitis at the graft-host junction, similar diagnostic and therapeutic maneuvers were performed.
Results:
Corneal scrapings and histopathologic examination were positive for numerous septate hyphae with endospores, consistent with a diagnosis of filamentous keratomycosis. Microbiologic isolation confirmed the diagnosis of Chrysosporium parvum. Similar diagnostic maneuvers for recurrent keratitis produced identical results.
Conclusion:
To our knowledge, this is the first case of Chrysosporium parvum keratomycosis.
Insights
This case report details the first instance of Chrysosporium parvum causing fungal keratitis, a serious corneal infection. Prompt diagnosis and treatment were crucial for managing this rare ocular fungal disease.
Area of Science:
- Ophthalmology
- Medical Mycology
- Infectious Diseases
Background:
- Ocular infections caused by filamentous fungi can lead to severe vision impairment.
- Chrysosporium species are typically associated with pulmonary infections, rarely presenting as a cause of keratitis.
Observation:
- A 43-year-old man presented with corneal stromal infiltrate and perforation of the left eye.
- Diagnosis was established through corneal scrapings, histopathology, and microbiologic isolation.
- Recurrent keratitis at the graft-host junction necessitated repeat diagnostic and therapeutic interventions.
Findings:
- Histopathology revealed septate hyphae with endospores, indicative of filamentous keratomycosis.
- Microbiologic culture confirmed the presence of Chrysosporium parvum.
- Recurrent infection showed identical diagnostic findings.
Implications:
- This case highlights Chrysosporium parvum as a potential pathogen in human fungal keratitis.
- It underscores the importance of considering unusual fungal agents in refractory or recurrent cases of keratomycosis.
- Early and accurate diagnosis is essential for appropriate antifungal therapy and visual preservation.