title: Severe fungal sclerokeratitis caused by Metarhizium anisopliae: a case report and literature review.
abstract: To date, there has been only one published report on the infectious sclerokeratitis caused by Metarhizium anisopliae, which is an entomopathogenic fungus. Regarding corneal infection, three reports have been published to date. Although the prognoses of the corneal infections are favourable, prognosis when scleral infection is involved is very poor. A 76-year-old patient presented with foreign body sensation in the left eye. Microscopic examination with Fungi Flora Y staining of the corneal scraping revealed fungal infection. The conjunctiva was melted by the infection over a wide area. Although intensive medications were administered, an emergency surgery was necessary because scleral thinning, corneal perforation and lens prolapse occurred. The fungal isolate was identified as M. anisopliae by sequencing the internal transcribed spacer region. Herein, we report the second known case worldwide of M. anisopliae sclerokeratitis, and we review the literature related to the ocular infections.
authors.affiliation: Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Toshi
authors.initials: T
authors.lastname: Toibana
authors.forename: Fumika
authors.initials: F
authors.lastname: Hotta
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mitamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yaguchi
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D057112:Corneal Perforation / Q000209:etiology; D003951:Diagnostic Errors; D054714:Echinocandins / Q000494:pharmacology; D015821:Eye Infections, Fungal / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D007564:Japan; D007634:Keratitis / Q000382:microbiology* / Q000628:therapy; D055666:Lipopeptides / Q000494:pharmacology; D008297:Male; D052981:Metarhizium / Q000187:drug effects / Q000302:isolation & purification* / Q000648:ultrastructure; D000077551:Micafungin; D015423:Scleritis / Q000382:microbiology* / Q000628:therapy
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin
keywords: Metarhizium anisopliae; ocular infections; sclerokeratitis