Alternaria fungal dacryocystitis with cutaneous fistula: a case report

Area of Science:

• Mycology
• Infectious Diseases
• Ophthalmology

Background:

• * Alternaria fungi are opportunistic pathogens, primarily causing cutaneous infections in immunocompromised individuals.
• * Oculomycosis, including keratomycosis and endophthalmitis, is a known manifestation, but rare.
• * Dacryocystitis and associated cutaneous fistulas are uncommon presentations of Alternaria infections.

Purpose of the Study:

• * To present a rare case of Alternaria dacryocystitis with a cutaneous fistula.
• * To emphasize the importance of considering fungal etiology in chronic dacryocystitis with non-healing wounds.
• * To highlight successful management strategies for this rare fungal infection.

Main Methods:

• * Case report of a diabetic patient with a non-healing medial canthal wound.
• * Re-examination of initial biopsy with fungal stains confirmed Alternaria infection (alternariosis).
• * Treatment involved surgical debridement and systemic antifungal therapy.

Main Results:

• * Successful diagnosis of Alternaria dacryocystitis through fungal stain re-evaluation of biopsy.
• * Complete resolution of infection following surgical intervention and antifungal treatment.
• * The patient recovered fully without recurrence.

Conclusions:

• * Fungal infections, such as alternariosis, should be considered in immunocompromised patients presenting with chronic dacryocystitis and cutaneous fistula.
• * Early recognition and appropriate treatment are crucial to prevent invasive disease progression.
• * This case underscores the diverse clinical spectrum of Alternaria infections.