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Cryptococcus albidus keratitis after corneal transplantation.

Luis E Fernández de Castro¹, Oday Al Sarraf, Joseph M Lally

¹Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina 29425, USA.

|September 15, 2005

Summary

This case report highlights a rare instance of donor-to-host transmission of Cryptococcus albidus following penetrating keratoplasty. The yeast was identified in donor tissue, causing persistent corneal infiltrates in a transplant recipient.

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Area of Science:

Ophthalmology
Infectious Diseases
Microbiology

Background:

Penetrating keratoplasty (corneal transplant) is a common procedure for vision restoration.
Fungal keratitis is a potential complication, though rare after corneal transplantation.
Donor-derived infections are an infrequent but serious risk in organ transplantation.

Observation:

A 69-year-old woman developed persistent corneal infiltrates 7 months after penetrating keratoplasty for Fuchs corneal dystrophy.
The patient's initial presentation mimicked sterile inflammation or other infectious etiologies.
Recurrent or persistent infiltrates post-keratoplasty warrant thorough investigation for uncommon pathogens.

Findings:

Cryptococcus albidus was successfully cultured from the donor corneal tissue during a repeat keratoplasty procedure.

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This finding strongly suggests that the yeast was present in the donor graft.

The yeast's presence in donor tissue points to a donor-to-host transmission route for the fungal keratitis.

Implications:

This case underscores the importance of donor screening and awareness of rare infectious complications in corneal transplantation.
It highlights Cryptococcus albidus as a potential, albeit unusual, cause of post-keratoplasty fungal keratitis.
Clinicians should consider donor-transmitted infections in cases of persistent or unusual corneal infiltrates after keratoplasty.