Korean J Lab Med.  2008 Aug;28(4):307-311. 10.3343/kjlm.2008.28.4.307.

A Case of Scedosporium apiospermum Keratitis Confirmed by a Molecular Genetic Method

• Yoon S
• Kim S
• Lee KA
• Kim H

• KMID: 854894
• DOI: http://doi.org/10.3343/kjlm.2008.28.4.307

Abstract

A 54-yr-old male, who was treated by chemotherapy for gastric cancer 15 months ago, presented to Yongdong Severance Hospital, Seoul, with complaints of pain in his right eye caused by a foreign body from the ground in the previous week. He had been treated with topical and oral antibacterial in addition to antifungal agents, but did not show significant clinical improvement. After a positive corneal culture with mold, topical amphotericin B was added to the initial regimen. The mold was identified as Scedosporium apiospermum by macroscopic and microscopic morphologies and the nucleotide sequences of a fungal PCR product showing 99% homology with those of S. apiospermum (EF151349). He recovered with good results at 25 days after corneal epithelial debridement. The early diagnosis of S. apiospermum keratitis is very important for proper treatment. It is recommended that molecular diagnostic methods such as fungal PCR and sequencing be done with conventional cultures whenever a fungal infection is suspected.

Keyword

Scedosporium apiospermum; Fungal keratitis; Fungal PCR

MeSH Terms

Amphotericin B/therapeutic use
Anti-Bacterial Agents/therapeutic use
Antifungal Agents/therapeutic use
Cornea/microbiology
Drug Therapy, Combination
Eye Infections, Fungal/*diagnosis/microbiology
Humans
Keratitis/*diagnosis/microbiology
Male
Middle Aged
Polymerase Chain Reaction
Scedosporium/genetics/growth & development/*isolation & purification
Sequence Analysis, DNA

Figure

• 

  Fig. 1. Dark gray colored cottony colony on Sabouraud dextrose agar after incubation for 2 weeks at 30°C; front (A), back (B).

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  Fig. 2. Microscopic morphology of Scedosporium apiospermum showing septate hyphae with simple long and short conidiophores (A). Conidiophore with annellation and solitary oval conidium (B) (Lactophenol cotton blue stain, (A) ×400, (B) original magnification ×1,000).

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