title: Role of confocal microscopy in deep fungal keratitis.
abstract: OBJECTIVE
  The purpose of this study was to assess the role of in vivo confocal microscopy in cases of fungal keratitis presenting with a deep stromal infiltrate.
  
  
  METHODS
  Retrospective, noncomparative case series.
  
  
  METHODS
  We reviewed the medical, microbiologic, and histopathologic data of 6 patients, whose clinical presentation was characterized by deep stromal or multifocal endothelial lesions. These patients were subjected to in vivo confocal microscopy on the day of presentation. All the patients underwent therapeutic penetrating keratoplasty. The excised corneal buttons were bisected and subjected to microbiologic and histopathologic examinations.
  
  
  RESULTS
  Microbiologic and/or histopathologic examination proved that the keratitis in all the 6 patients was caused by filamentous fungi. Five corneal buttons were positive for the fungus on histopathologic examination. Four specimens grew out fungus on microbiologic examination. In 5 (83%) cases, confocal microscopy revealed double-walled, septate, linear branching structures resembling fungal filaments.
  
  
  CONCLUSIONS
  In vivo confocal microscopy can be a useful diagnostic tool in patients presenting with deep stromal lesions.
authors.affiliation: Cornea and Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Orissa, India. sujatadas@lvpei.org
authors.forename: Sujata
authors.initials: S
authors.lastname: Das
authors.forename: Monica
authors.initials: M
authors.lastname: Samant
authors.forename: Prashant
authors.initials: P
authors.lastname: Garg
authors.forename: Pravin Krishna
authors.initials: PK
authors.lastname: Vaddavalli
authors.forename: Geeta K
authors.initials: GK
authors.lastname: Vemuganti
mesh_terms: D000328:Adult; D003315:Cornea / Q000382:microbiology; D003319:Corneal Stroma / Q000473:pathology*; D015821:Eye Infections, Fungal; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult