Emerging corneal pathogens: First report of Pseudopestalotiopsis theae keratitis

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Corneal infections can lead to vision loss.
• Fungal keratitis is a significant cause of visual impairment, particularly in tropical regions.
• Trauma with vegetative matter is a known risk factor for fungal keratitis.

Observation:

• A 55-year-old female presented with a corneal ring infiltrate after trauma from a wooden stick.
• Microscopic examination of corneal scrapings revealed septate hyaline fungal filaments.
• Fungal cultures grew white, feathery colonies with black dots.

Findings:

• Lactophenol cotton blue mounts showed characteristic Pestalotiopsis spores.
• DNA sequencing identified the fungus as Pseudopestalotiopsis theae with 99% similarity.
• The patient achieved complete resolution of the keratitis with topical and oral antifungal therapy.

Implications:

• This case represents the first reported instance of Pseudopestalotiopsis keratitis following vegetative trauma.
• It underscores the importance of accurate fungal identification using molecular methods like DNA sequencing.
• Early diagnosis and appropriate antifungal treatment are crucial for managing rare fungal keratitis cases.