Related Experiment Video
Updated: Apr 5, 2026
Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
Cladosporium keratitis - a case report and literature review
Steve Chih-Hsuan Cheng1, Ying-Yu Lin2, Chien-Neng Kuo3,4
1Department of Medical Education, Chang Gung Memorial Hospital, No.6, W. Sec., Chia-Pu Rd., Puzi City, Chiayi County, 61363, Taiwan. stevecheng@cgmh.org.tw.
Background:
Fungal keratitis is one of the major causes of infectious keratitis in tropical countries. Symptoms of fungal keratitis consist of blurred vision, redness, tearing, photophobia, pain and foreign body sensation. If not treated effectively, it could lead to blindness. Common causes include Candida spp., Fusarium spp. and Aspergillus spp.. With the limited choices of topical antifungal agents, we were faced with Cladosporium keratitis, a rare cause of fungal keratitis.
Case Presentation:
A 62-year-old Asian male construction worker came to us with intense ocular pain, injection of the conjunctiva, blurred vision, and foreign body sensation in his left eye. His visual acuity was 20/40 OD and 20/400 OS. Slit-lamp exam revealed a corneal ulcer with feathery margin and Descemet's membrane folding. The culture yielded Cladosporium species.. The patient did not show improvements after applying topical natamycin (5 %), topical amphotericin B (1mg/ml), topical fluconazole (2mg/ml) and oral ketoconazole (200mg). After shifting the medical regimen to voriconazole via topical and systemic routes (1mg/ml and 200mg respectively), the keratitis was controlled.
Conclusions:
Fungal keratitis remains a challenge for ophthalmologists as there is no evidence suggesting any particular drug or combination of drugs is more effective than another. A review of common topical antifungal agents was done. Voriconazole could be a good choice for treating corneal infection by Cladosporium species.
Insights
Fungal keratitis, a serious eye infection, can lead to blindness. Voriconazole is a promising treatment for Cladosporium keratitis, a rare fungal infection, especially when other antifungals fail.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal keratitis is a significant cause of infectious blindness in tropical regions.
- Common causative agents include Candida, Fusarium, and Aspergillus species.
- Cladosporium keratitis presents a rare but challenging clinical scenario due to limited topical antifungal options.
Observation:
- A 62-year-old male presented with severe ocular pain, blurred vision, and corneal ulceration with feathery margins.
- Initial treatment with topical natamycin, amphotericin B, fluconazole, and oral ketoconazole proved ineffective.
- Corneal cultures confirmed the presence of Cladosporium species.
Findings:
- Voriconazole, administered both topically and systemically, successfully controlled the Cladosporium keratitis.
- This case highlights the potential efficacy of voriconazole in treating rare fungal corneal infections.
Implications:
- Voriconazole represents a viable therapeutic option for recalcitrant Cladosporium keratitis.
- Further research is warranted to establish optimal treatment protocols for rare fungal keratitis.
- This case contributes to the understanding of managing challenging fungal eye infections.
More Related Videos
07:50A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
07:29Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015