Corneal ulcer due to Neocosmospora vasinfecta in an immunocompetent patient.
We report a case of Neocosmospora vasinfecta keratitis in a 55-year-old man. While the patient did not recall any specific trauma or eye injury, he might have sustained a trivial wound during the course of his duties as a farmer. Direct examination of corneal scrapings revealed fungus filaments. As topical treatment with natamycin and econazole and subsequent systemic ketoconazole therapy failed, a full thickness therapeutic keratoplasty was performed. Post-operative treatment with amphotericin B and clotrimazole combined with cyclosporine resulted in a complete cure. The residual corneal infiltration in the recipient cornea became clear in a week. The fungal isolate was initially identified as a Fusarium species, but later reidentified through the use of morphological characteristics and sequence analysis of the internal transcribed spacer region as N. vasinfecta. The latters is a Hypocrealean fungus not hitherto reported as a causative agent of keratomycosis.
Manikandan
P
P
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, India. micro@cbe.aravind.org
Vismer
H F
HF
Kredics
L
L
Dóczi
I
I
Marasas
W F O
WF
Bhaskar
M
M
Anita
R
R
Revathi
R
R
Narendran
V
V
D001228:Aspergillosis / Q000382:microbiology* / Q000628:therapy; D003320:Corneal Ulcer / Q000382:microbiology* / Q000628:therapy; D004271:DNA, Fungal / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D015821:Eye Infections, Fungal / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D006999:Hypocreales / Q000166:cytology / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged
D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer