[Persistent contact lens-associated keratitis]

A 43-year-old woman presented with a 2-month history of contact lens-associated keratitis and corneal ulceration on the left eye. Without having isolated the pathogenic agent, a calculated anti-infective and anti-inflammatory therapy had already been administered with no signs of improvement. Filamentous fungi (Acremonium sp) were found in the scraping material and the contact lens solution. A keratoplasty à chaud was necessary despite immediate initiation of pathogen-specific therapy. Early identification of the pathogen via corneal debridement and culturing are standard procedures in order to initiate a specific therapy and prevent ulceration which can threaten the visual outcome.