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string(1061) "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.
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string(225) "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."
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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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Article | KnE Open
Journal of Ophthalmic and Vision Research
ISSN: 2008-322X
The latest research in clinical ophthalmology and vision science
Pigmented Corneal Ulcer
Authors:
Sonam Yangzes Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Parul Chawla Gupta Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Vivek Jha Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Jagat Ram drjagatram@gmail.com Department 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.
3
Shreesha K Kodavoor, Vinoth Ramesh, Ramamurthy Dandapani (2025)
Fingerprint on the cornea - Rare occurrence in a corneal scar,
Indian Journal of Ophthalmology - Case Reports
Volume: 5, Issue: 1, First Page: 192
10.4103/IJO.IJO_2728_24
Alejandro Acosta, Estefania Ramirez Marquez, Angel Aguayo, Alejandro Perez, Lília Rivera, Armando L Oliver (2023)
Managing a Pigmented Corneal Ulcer in a 58-Year-Old Patient,
Cureus
10.7759/cureus.46850
Alexandra Mpakosi, Christiana Kaliouli-Antonopoulou (2024)
Immune Mechanisms of Filamentous Fungal Keratitis,
Cureus
10.7759/cureus.61954
