J Korean Ophthalmol Soc.  2024 May;65(5):337-341. 10.3341/jkos.2024.65.5.337.

Colletotrichum Jasminigenum-induced Infectious Sclerokeratitis: A Case Report

• Jeong IS
• Yoo WS
• Chung IY
• Seo SW
• Byun JH
• Kim SJ

• KMID: 2555485
• DOI: http://doi.org/10.3341/jkos.2024.65.5.337

Abstract

Purpose
We present a case of Colletotrichum jasminigenum (C. jasminigenum)-induced Infectious sclerokeratitis.
Case summary
An 81-year-old patient presented to our hospital with left eye pain and decreased vision that had started 7 days prior. He had a history of left eye pterygium excision a decade earlier. Examination using a slit lamp revealed a nasal conjunctival defect, scleral melting, deep stromal infiltration with a feathery margin, and hypopyon. Considering the suspicion of fungal sclerokeratitis, we performed a smear analysis and potassium hydroxide (KOH) and culture testing. The KOH test revealed hyphae, leading to systemic fluconazole and topical fluconazole and natamycin. Subsequently, we performed surgery, including debridement of the necrotic scleral area, conjunctival rotation and scleral grafting, and anterior chamber irrigation with intracameral and intravitreal voriconazole injections, due to progressive corneal infiltration and scleral melting. Additionally, we switched to using systemic and topical voriconazole. The culture yielded fungi, with DNA sequencing confirming C. jasminigenum as the causative agent. Following treatment, the lesion improved, and no signs of recurrence were observed.
Conclusions
Voriconazole is an effective treatment for C. jasminigenum-induced fungal sclerokeratitis.

Keyword

Colletotrichum jasminigenum, Infectious sclerokeratitis, Keratitis, Scleritis, Voriconazole