Fungal keratitis caused by a rare ocular pathogen, Gjaerumia minor: A case report

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Fungal keratitis is a severe eye infection with potentially devastating visual outcomes.
• It is prevalent globally, particularly in tropical regions.
• Uncommon fungal species can cause keratitis, especially in immunocompromised individuals.

Purpose of the Study:

• To report a case of fungal keratitis caused by the rare yeast Gjaerumia minor in an adult diabetic patient in Saudi Arabia.
• To detail the clinical presentation, laboratory findings, and treatment response.
• To emphasize the consideration of fungal keratitis in non-responsive ocular infections.

Main Methods:

• Clinical examination and patient history.
• Corneal scraping for mycological culture on Sabouraud dextrose agar.
• Identification of the yeast using large subunit ribosomal RNA gene sequencing.
• Treatment with topical Amphotericin B and oral fluconazole.

Main Results:

• The patient presented with severe fungal keratitis in the left eye.
• Gjaerumia minor was identified as the causative agent.
• The patient showed significant clinical improvement with antifungal therapy, including healing of the epithelial defect and regression of infiltration.
• The hypopyon resolved, and visual acuity improved.

Conclusions:

• Gjaerumia minor is a rare cause of fungal keratitis, and this is the first reported case in Saudi Arabia.
• Fungal keratitis should be suspected in cases of ocular infections unresponsive to standard antibacterial treatments.
• Early diagnosis and appropriate antifungal therapy are crucial for successful management and visual preservation.