Posttraumatic phycomycosis of the anterior segment.

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Keratomycosis, a fungal infection of the cornea, is uncommon, particularly in immunocompetent individuals.
• Phycomycosis (mucormycosis) of the eye typically affects patients with compromised systemic immunity.

Observation:

• A 24-year-old male developed keratomycosis and anterior chamber infection with Rhizopus sp. after a corneal perforation from a soil-contaminated screwdriver.
• Cultures and histopathology confirmed the fungal infection in the corneal wound and anterior chamber.
• The patient had no predisposing systemic conditions, but recent topical and sub-Tenon's corticosteroid use may have impaired local ocular immunity.

Findings:

• Excisional keratoplasty was a key component in the successful treatment of this severe ocular fungal infection.
• The case highlights the potential for opportunistic fungal infections following ocular trauma, even without systemic immunosuppression.

Implications:

• This case underscores the importance of considering fungal etiologies in severe post-traumatic endophthalmitis.
• Aggressive surgical management combined with appropriate antifungal therapy is essential for limb and vision salvage in such cases.
• The role of localized corticosteroid use in potentiating opportunistic infections warrants further investigation.