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First case of fungal keratitis caused by Pestalotiopsis clavispora

Yu Monden1, Shohaku Yamamoto1, Ryoji Yamakawa1

  • 1Department of Ophthalmology, Kurume University School of Medicine, Fukuoka, Tokyo.

Clinical Ophthalmology (Auckland, N.Z.)
|December 19, 2013
PubMed
Abstract

Insights

This case report details the successful treatment of rare fungal keratitis caused by Pestalotiopsis clavispora. Molecular identification and antifungal susceptibility testing guided effective therapy for this challenging corneal infection.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Fungal keratitis is a serious ocular infection, often challenging to diagnose and treat.
  • Recurrent cases and those caused by rare fungal species require specific diagnostic and therapeutic approaches.

Observation:

  • A 73-year-old male with a history of multiple ocular surgeries and corticosteroid use presented with recurrent keratitis.
  • Corneal scrapings revealed a filamentous fungus, initially treated empirically.
  • Relapse occurred after initial treatment discontinuation, necessitating further investigation.

Findings:

  • Molecular techniques identified the causative agent as Pestalotiopsis clavispora, a rare cause of human fungal keratitis.
  • Antifungal susceptibility testing guided the selection of topical and intravenous micafungin.
  • Successful resolution of the corneal infiltrate was achieved with targeted antifungal therapy.

Implications:

  • Accurate identification of fungal pathogens, including rare species, is crucial for effective treatment of fungal keratitis.
  • Antifungal susceptibility testing provides essential data for selecting appropriate and effective antifungal agents.
  • This case highlights the importance of a comprehensive diagnostic and therapeutic strategy for managing complex fungal keratitis.
Keywords:
Pestalotiopsis clavisporaantifungal susceptibility testfungal keratitismolecular identificationplant pathogen

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