Post-traumatic fungal keratitis caused by Carpoligna sp

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Fungal keratitis is a significant cause of visual impairment, particularly in agricultural settings.
• Corneal lacerations present a risk for microbial inoculation and subsequent infection.
• Early and accurate diagnosis is crucial for effective management of fungal keratitis.

Observation:

• A gardener developed severe infectious keratitis with descemetocoele two months after a corneal laceration.
• Fungal elements were identified on culture, with no bacterial presence.
• The patient was treated with oral and topical voriconazole, followed by topical natamycin 5%.

Findings:

• Diagnosis of Carpoligna pleurothecii keratitis was confirmed via PCR amplification of the 28s ribosomal RNA gene.
• Treatment with voriconazole and natamycin resulted in successful healing of the keratitis without corneal perforation.
• The patient was left with a central stromal scar, and corticosteroids were avoided.

Implications:

• This case establishes Carpoligna species as a cause of human fungal keratitis.
• Voriconazole and natamycin are effective treatments for Carpoligna pleurothecii keratitis.
• Further research into Carpoligna species and their pathogenic potential in ocular infections is warranted.