Chronic Canaliculitis Due to a Novel Fungal Organism: Scedosporium

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Canaliculitis is a rare lacrimal disorder, typically caused by bacterial pathogens like Streptococcus, Staphylococcus, or Actinomyces.
• Fungal infections of the lacrimal canaliculus are uncommon, with Pseudomonas species implicated in cases involving punctal plugs.

Purpose of the Study:

• To report the first documented case of canaliculitis caused by Scedosporium species, a group of filamentous fungi.
• To highlight the clinical presentation and successful management of this rare fungal lacrimal infection.

Main Methods:

• Case report detailing a patient with canaliculitis.
• Surgical intervention included punctoplasty with curettage.
• Antifungal treatment involved topical voriconazole and systemic azole therapy.

Main Results:

• The patient presented with canaliculitis secondary to Scedosporium species infection.
• Successful treatment outcomes were achieved with a combination of surgical debridement and antifungal medications.
• This represents the first reported instance of Scedosporium-induced fungal canaliculitis.

Conclusions:

• Scedosporium species should be considered in the differential diagnosis of canaliculitis, particularly in immunocompromised individuals.
• Prompt diagnosis and appropriate antifungal therapy are crucial for managing fungal canaliculitis.
• This case expands the known etiologies of lacrimal canaliculitis to include Scedosporium fungi.