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Pigmented Corneal Ulcer.

Sonam Yangzes¹, Parul Chawla Gupta¹, Vivek Jha¹

¹Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Journal of Ophthalmic & Vision Research

|December 26, 2019

Summary

This summary is machine-generated.

This case report details a rare fungal keratitis caused by Bipolaris hawaiiensis. Prompt treatment with intracameral amphotericin B successfully managed the infection, avoiding surgery.

Keywords:

Pigmented Corneal Ulcer Keratitis

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Area of Science:

Ophthalmology
Mycology
Infectious Diseases

Background:

Fungal keratitis is a significant cause of visual impairment, particularly in tropical and subtropical regions.
Dematiaceous fungi, characterized by dark pigmentation, are an important group of fungal pathogens causing corneal infections.
Bipolaris hawaiiensis is a rare but recognized cause of fungal keratitis, often associated with trauma.

Observation:

A 55-year-old male presented with a corneal ulcer following ocular trauma with vegetative matter.
Clinical examination revealed a distinctive brownish-black pigmented plaque with surrounding corneal infiltrates.
Microscopic examination of corneal scrapings showed septate hyphae, and fungal culture identified Bipolaris species.

Findings:

The patient was treated with topical and oral antifungal agents, including natamycin, voriconazole, and itraconazole.
Intracameral amphotericin B (5 μg/mL) was administered as a subsequent treatment.
The corneal infection showed a favorable response to the multimodal antifungal therapy.

Implications:

Brown pigmented corneal infiltrates serve as a crucial clinical indicator for dematiaceous fungal infections.
Bipolaris hawaiiensis represents a rare etiology of corneal phaeohyphomycosis.
Successful management with intracameral amphotericin B highlights its therapeutic potential, potentially preventing the need for corneal transplantation.