Optic atrophy due to Curvularia lunata mucocoele

The authors report on the case of a 57-year-old male who presented with poor vision of his right eye. He had right optic nerve atrophy secondary to neural compression by a mucocoele in the pituitary fossa. The patient underwent transphenoidal resection of the mucocoele. Microbiology revealed Curvularia lunata and Enterobacter aerogenes present in the specimen. He was treated with liposomal Amphotericin B and meropenem. Assessment of vision post-operatively demonstrated improvement in his visual acuity. On reviewing the published literature, this case was found to be the first in which Curvularia had caused optic neuropathy. There have been only five previously documented reports of Curvularia causing CNS infections. This case demonstrates the importance of obtaining a tissue diagnosis together with appropriate surgical and medical management in the treatment of invasive fungal disease.