Korean J Med Mycol.  2015 Jun;20(2):27-33. 10.17966/KJMM.2015.20.2.27.

A Case of Alternaria alternata Keratitis Isolated from Corneal Tissue

• Kang KM
• Kim HK
• Lee HS
• Song KE
• Lee SH
• Lee WJ
• Lee WK

• KMID: 2132865
• DOI: http://doi.org/10.17966/KJMM.2015.20.2.27

Abstract

A 71-year-old man presented with pain in the left eye that revealed a 3x3 mm deep corneal stromal infiltrate, with a 2x2 mm epithelial defect. The patient started topical moxifloxacin, voriconazole 2%, and natamycin for 2 weeks. However, the treatment was not effective and the corneal infiltration worsened. Subsequently, the patient underwent therapeutic penetrating keratoplasty. Thick brown/gray mold colonies on Potato Corn Meal Tween 80 agar was isolated from excised corneal tissue and on slide culture many septated, and club-shaped ascospores were revealed. Histological findings also showed numerous hyphae scattered in corneal tissue. A. alternata colonies were confirmed by 18S rRNA sequencing. Intracameral voriconazole was injected every other day for 2 weeks to eliminate remaining fungi on the deep corneal stroma. The remaining corneal infiltration was improved one month after the injection. During 5 months postoperative follow up, the infection did not recurred. In conclusion, deep corneal infection of A. alternata was effectively treated with intracameral voriconazole injection.

Keyword

Alternaria alternata; Cornea culture; Intracameral voriconazole injection

MeSH Terms

Agar
Aged
Alternaria*
Corneal Stroma
Follow-Up Studies
Fungi
Humans
Hyphae
Keratitis*
Keratoplasty, Penetrating
Meals
Natamycin
Polysorbates
Solanum tuberosum
Zea mays
Agar
Natamycin
Polysorbates