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Corneal ulcer caused by Bipolaris hawaiiensis
V Anandi1, N B Suryawanshi, G Koshi
1Department of Microbiology, Christian Medical College and Hospital, Vellore, India.
Summary
A leprosy patient developed a corneal ulcer after eye injury. Fungal elements identified as Bipolaris hawaiiensis were isolated, and treatment with nystatin ointment was successful, though vision was not fully restored.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Leprosy can present with various ocular complications.
- Corneal ulcers are a serious ophthalmic condition that can lead to vision loss.
Observation:
- A leprosy patient sustained a right eye injury, subsequently developing a corneal ulcer with hypopyon.
- Direct examination of corneal scrapings revealed septate, branched, dematiaceous hyphal elements.
Findings:
- Repeated cultures of corneal scrapings on Sabouraud's glucose and brain heart infusion agars consistently isolated Bipolaris hawaiiensis.
- The patient showed a positive response to topical nystatin ointment treatment.
Implications:
- Bipolaris hawaiiensis is identified as a causative agent of fungal keratitis in a leprosy patient.
- While antifungal treatment can be effective, corneal opacity may persist, impacting visual acuity.
- This case highlights the importance of considering fungal infections in the differential diagnosis of corneal ulcers, especially in immunocompromised individuals or those with underlying conditions like leprosy.