title: Corneal Phaeohyphomycosis Caused byBipolaris hawaiiensis.
abstract: OBJECTIVE
  To report a rare case of keratitis infected byBipolaris hawaiiensis.
  
  
  METHODS
  A patient who was diagnosed as fungal keratitis caused byB. hawaiiensiswas retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes.
  
  
  RESULTS
  A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identifiedB. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty.
  
  
  CONCLUSIONS
  B. hawaiiensisis a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Winai
authors.initials: W
authors.lastname: Chaidaroon
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Sumet
authors.initials: S
authors.lastname: Supalaset
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Napaporn
authors.initials: N
authors.lastname: Tananuvat
authors.affiliation: Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Nongnuch
authors.initials: N
authors.lastname: Vanittanakom
keywords: Bipolaris hawaiiensis; Dematiaceous fungus; Keratitis; Phaeohyphomycosis