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Phaeoisaria sp. fungal keratitis resembling corneal rust residue: a case report
YingHan Zhao1,2, MengYao Zhang1,2, Jing Hong1,2
1Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Background:
Fungal keratitis can develop after plant injury or after prolonged glucocorticoid use. Typical manifestations include corneal infiltrates, satellite lesions, plaques, and an immune ring. Some cases exhibit atypical signs, requiring reliance on etiological examination. Notably, fungi previously deemed nonpathogenic to humans can cause keratitis with rare clinical manifestations. This report details the clinical signs and successful treatment outcomes of keratitis caused by Phaeoisaria sp.
Case Presentation:
A 51-year-old man visited the ophthalmology clinic with ongoing eye pain and a history of corneal iron foreign body removal two months earlier. Examination revealed a brownish ulcer with clear borders, swelling, and redness, indicating the presence of rust. Although the initial cultures were negative, a rare fungus called Phaeoisaria sp. was eventually identified as causative agent. The patient completed six weeks of antifungal treatment and showed no signs of recurrence at the 7-month follow-up visit.
Conclusions:
Patients with a history of corneal foreign bodies should also be informed of the possibility of atypical corneal fungal infection.
Insights
A rare fungal keratitis caused by Phaeoisaria sp. occurred in a patient with a corneal foreign body. Prompt diagnosis and antifungal treatment led to successful recovery, highlighting the need to consider atypical infections.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal keratitis presents with typical signs like infiltrates and immune rings, but atypical presentations can occur.
- Fungi previously considered nonpathogenic can cause rare clinical manifestations of keratitis.
- Corneal foreign bodies and glucocorticoid use are risk factors for fungal keratitis.
Purpose of the Study:
- To report a rare case of fungal keratitis caused by Phaeoisaria sp.
- To describe the clinical signs and successful treatment of this atypical infection.
- To emphasize the importance of considering fungal etiologies in corneal infections, especially with a history of foreign bodies.
Main Methods:
- A 51-year-old male presented with eye pain and a history of corneal iron foreign body removal.
- Clinical examination revealed a brownish corneal ulcer with associated inflammation.
- Despite initial negative cultures, Phaeoisaria sp. was eventually identified as the causative agent.
Main Results:
- The patient was diagnosed with fungal keratitis due to Phaeoisaria sp.
- Successful treatment was achieved with a six-week course of antifungal therapy.
- No recurrence of infection was observed at the 7-month follow-up.
Conclusions:
- Fungal keratitis can present atypically, even with rare fungal species.
- Patients with a history of corneal foreign bodies are at risk for atypical fungal infections.
- Early etiological diagnosis and appropriate antifungal treatment are crucial for successful outcomes.
