Post-traumatic fungal keratitis caused by Carpoligna sp.
OBJECTIVE
To report the first case of fungal keratitis caused by presumed Carpoligna species.


METHODS
A 37-year-old gardener sustained a full-thickness, stellate corneal laceration while cutting wood outdoors with a circular saw. Two months after surgical repair, he developed a severe infectious keratitis with descemetocoele at the apex of the original stellate laceration.


RESULTS
Culture results confirmed fungal elements without evidence of bacteria. Oral and topical voriconazole were initiated. Due to compliance and cost issues, voriconazole was replaced with natamycin 5% prior to discharge from hospital. The patient improved and healed without perforation. The patient was left with a central stromal scar. DNA extraction from the fungal colony allowed PCR amplification of the 28s ribosomal RNA region of the fungus that led to the diagnosis of Carpoligna pleurothecii. Corticosteroids were never used during the patient's treatment.


CONCLUSIONS
This is the first reported case of infectious keratitis caused by presumed Carpoligna species. The treatment for Carpoligna pleurothecii keratitis includes voriconazole, natamycin, and possibly amphotericin B.
Chew
Hall F
HF
Cornea Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA, USA. hall.chew@utoronto.ca
Jungkind
Donald L
DL
Mah
Dean Y
DY
Raber
Irving M
IM
Toll
Adam D
AD
Tokarczyk
Mindy J
MJ
Cohen
Elisabeth J
EJ
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001483:Base Sequence; D065306:Corneal Injuries; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004271:DNA, Fungal / Q000235:genetics; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005131:Eye Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D003904:Mitosporic Fungi / Q000235:genetics / Q000302:isolation & purification*; D008969:Molecular Sequence Data; D010866:Natamycin / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011743:Pyrimidines / Q000627:therapeutic use; D012331:RNA, Fungal / Q000235:genetics; D012339:RNA, Ribosomal, 28S / Q000235:genetics; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D004271:DNA, Fungal; D011743:Pyrimidines; D012331:RNA, Fungal; D012339:RNA, Ribosomal, 28S; D014230:Triazoles; D000666:Amphotericin B; D010866:Natamycin; D065819:Voriconazole