Aspergillus fumigatus keratitis with wreath pattern infiltrates.
OBJECTIVE
To report a case of Aspergillus fumigatus keratitis with clinical features simulating Nocardia keratitis and to highlight the utility of microbiologic investigation in the successful management of infectious keratitis.


METHODS
Case report.


RESULTS
A 62-year-old man presented with complaints of pain, redness, and watering of 10 days' duration in his right eye. Direct microscopic observation of smears of corneal scrapings revealed a fungal etiology. The patient was treated with 5% natamycin eye drops and 1% atropine sulphate eye drops and was advised to visit the hospital for observation. During his visit to the hospital on day 10 after medication, the eye demonstrated a wreath pattern corneal infiltrate that simulated Nocardia keratitis. The fungus grown from culture of corneal scraping was identified as A. fumigatus.


CONCLUSIONS
This report highlights the significance of subjecting corneal scrapings from suspected cases of infectious keratitis to microbiologic evaluation and emphasizes the fact that a complete microbiologic work-up helps in establishing a definitive etiologic diagnosis and initiating specific antimicrobial therapy.
Sridhar
M S
MS
Cornea Service, L.V. Prasad Eye Institute, Hyderabad, India.
Gopinathan
U
U
Garg
P
P
Rao
G N
GN
D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D001285:Atropine / Q000627:therapeutic use; D003315:Cornea / Q000382:microbiology; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007634:Keratitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000627:therapeutic use; D010866:Natamycin / Q000627:therapeutic use
D000935:Antifungal Agents; D009184:Mydriatics; D001285:Atropine; D010866:Natamycin