Journal of Ophthalmic and Vision Research

ISSN: 2008-322X

The latest research in clinical ophthalmology and vision science

Pigmented Corneal Ulcer

Published date:Oct 24 2019

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: October–December 2019, Volume 14, Issue 4

Pages:506 – 508

DOI: 10.18502/jovr.v14i4.5461

Authors:

Sonam YangzesDepartment of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Parul Chawla GuptaDepartment of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Vivek JhaDepartment of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Jagat Ramdrjagatram@gmail.comDepartment of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Abstract:

Purpose: To report the clinical characteristics, laboratory findings, and treatment of a rare case of keratitis caused by pigmented fungi Bipolaris hawaiiensis.

Case Report: A 55-year-old man presented with a history of trauma with vegetative matter in his left eye. Slit lamp biomicroscopic examination revealed the presence of a brownish-black pigmented plaque with surrounding infiltrates. Corneal scrapings revealed multiple septate hyphae. Culture revealed growth of the Bipolaris species. The patient was treated with topical natamycin 5%, topical voriconazole 1%, and oral itraconazole followed by intracameral amphotericin B (5 μg/mL). The patient responded well to the treatment.

Conclusion: Brown pigmented infiltrates are an important clinical feature of dematiaceous fungi. B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. Our patient responded well to intracameral amphotericin B, which obviated the need for penetrating keratoplasty.

Keywords: Corneal Ulcer, Keratitis, Pigmented

References:

1. Chowdhary A, Singh K. Spectrum of fungal keratitis in North India. Cornea 2005;24:8–15.

2. Tanure MA, Cohen EJ, Sudesh S, Rupuano CJ, Laibson PR. Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea 2000;19:307–312.

3. Garg P, Gopinathan U, Chaudhary K, Rao GN. Keratomycosis: clinical and microbiologic experience with dematiaceous fungi. Ophthalmology 2000;107:574–580.

4. Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN. The epidemiological and laboratory results of fungal keratitis: a 10 year review at referral eye care center in South India. Cornea 2002;21:555–559.

5. Ajello L, Georg LK, Steigbigel RT, Wang CJ. A case of phaeohyphomycosis caused by a new species of phialophora. Mycologia 1974;66:490–498.

6. Cunha KC, Sutton DA, Fothergill AW, Cano J, Gené J, Madrid H, et al. Diversity of Bipolaris species in clinical samples in the United States and their antifungal susceptibility profiles. J Clin Microbiol 2012;50:4061–4066.

7. Anandi V, Suryawanshi NB, Koshi G, Padhye AA, Ajello L. Corneal ulcer caused by Bipolaris hawaiiensis. J Med Vet Mycol 1988;26:301–306.

8. Bashir G, Hussain W, Rizvi A. Bipolaris hawaiiensis keratomycosis and endophthalmitis. Mycopathologia 2009;167:51–53.

9. Garg P, Vemuganti GK, Chatarjee S, Gopinathan U, Rao GN. Pigmented plaque presentation of Dematiaceous fungal keratitis: a Clinicopathologic Correlation. Cornea 2004;23:57–576.

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