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Scytalidium keratitis: case report in a human eye.
Qais A Farjo1, Rand S Farjo, Ayad A Farjo
1Vision Associates, Toledo, OH 43615, USA. qaisf@umich.edu
Cornea
|December 19, 2006
Summary
This case report details a Scytalidium fungal keratitis infection in a young woman, presenting as an atypical corneal infiltrate. Intensive topical and oral antifungal therapy successfully eradicated the infection, restoring vision.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal keratitis is a significant cause of visual impairment, particularly in tropical and subtropical regions.
- Scytalidium species, commonly found in soil and on plants, are increasingly recognized as opportunistic pathogens causing infections in humans, including keratitis.
Observation:
- A 21-year-old female equestrian presented with persistent keratitis and photophobia in her right eye following a volleyball injury.
- Initial presentation included an atypical reticular corneal infiltrate with a surrounding immune-like ring.
- Despite initial negative cultures and treatment with topical steroids, the keratitis persisted, suggesting an unusual etiology.
Findings:
- Repeat corneal scrapings and cultures ultimately identified Scytalidium species as the causative agent of the keratitis.
- The patient was treated with topical amphotericin B 0.15% and oral fluconazole 200 mg twice daily.
- This intensive antifungal regimen successfully eradicated the Scytalidium infection.
Implications:
- This case highlights the potential for Scytalidium species to cause indolent and atypical presentations of fungal keratitis.
- Prompt and aggressive combination therapy with topical and oral antifungals is crucial for successful treatment outcomes.
- Ophthalmologists should consider less common fungal pathogens in cases of persistent or atypical keratitis, especially in individuals with relevant exposure histories.
