title: First case of fungal keratitis caused by Pestalotiopsis clavispora.
abstract: OBJECTIVE
  To report the isolation of Pestalotiopsis clavispora from the cornea of a patient with recurrent keratitis.
  
  
  METHODS
  A 73-year-old male gardener presented with conjunctival injection and an oval infiltrate with feathery margins in the temporal half of the cornea in the right eye. His ocular history in the right eye included cataract surgery, five episodes of herpes simplex keratitis, three glaucoma surgeries, and bullous keratopathy. He had been treated with corticosteroids for years. Light microscopy of corneal scrapings revealed a filamentous fungus, and fungal keratitis was diagnosed. Treatment with topical voriconazole and pimaricin ointment was commenced. One month later, the infiltrate resolved. The antifungal agents were discontinued 7 months later, and keratitis relapsed 4 days after the discontinuation. The fungus was isolated and identified by molecular techniques as P. clavispora. Based on the results of antifungal susceptibility testing, treatment with topical and intravenous micafungin was initiated. The corneal infiltrate resolved 1 month after the relapse.
  
  
  CONCLUSIONS
  Molecular identification of the pathogen, and antifungal susceptibility testing, are useful in treating patients with fungal keratitis caused by a rare human pathogen.
authors.affiliation: Department of Ophthalmology, Kurume University School of Medicine, Fukuoka, Tokyo.
authors.forename: Yu
authors.initials: Y
authors.lastname: Monden
authors.affiliation: Department of Ophthalmology, Kurume University School of Medicine, Fukuoka, Tokyo.
authors.forename: Shohaku
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Ophthalmology, Kurume University School of Medicine, Fukuoka, Tokyo.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yamakawa
authors.affiliation: Laboratory for Clinical Investigation, Tokyo.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Sunada
authors.affiliation: Department of Infection Control and prevention, Osaka University Hospital, Osaka, Tokyo.
authors.forename: Seishi
authors.initials: S
authors.lastname: Asari
authors.affiliation: Teikyo University Institute of Medical Mycology, Tokyo.
authors.forename: Koichi
authors.initials: K
authors.lastname: Makimura
authors.affiliation: Division of Ophthalmology and Visual Sciences, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Inoue
keywords: Pestalotiopsis clavispora; antifungal susceptibility test; fungal keratitis; molecular identification; plant pathogen