Rhodotorula keratitis: a rarely encountered ocular pathogen.

Area of Science:

• Ophthalmology
• Medical Mycology

Background:

• Fungal keratitis poses a significant threat to vision.
• Rhodotorula keratitis is a rare form of fungal keratitis with historically poor prognoses.
• In vivo confocal microscopy is an advanced diagnostic tool for ocular infections.

Observation:

• A young adult developed severe keratitis after ocular trauma.
• Infection was identified as Rhodotorula mucilaginosa via culture and confirmed with in vivo confocal microscopy.
• The organism exhibited pseudomycelium formation in vivo, a rarely observed morphology.

Findings:

• Early diagnosis and prompt treatment with topical voriconazole and amphotericin B led to complete resolution of the corneal infiltrate.
• The patient achieved excellent visual recovery (20/20) without surgical intervention.
• Confocal microscopy facilitated early diagnosis and management of this atypical fungal keratitis.

Implications:

• Rhodotorula keratitis can be effectively managed with topical antifungal therapy if diagnosed early.
• In vivo confocal microscopy is a valuable tool for diagnosing and guiding treatment of fungal keratitis.
• This case expands the understanding of Rhodotorula morphology in vivo and its clinical presentation.