Corneal ulcer due to Neocosmospora vasinfecta in an immunocompetent patient

Med Mycol. 2008 May;46(3):279-84. doi: 10.1080/13693780701625149.

Abstract

We report a case of Neocosmospora vasinfecta keratitis in a 55-year-old man. While the patient did not recall any specific trauma or eye injury, he might have sustained a trivial wound during the course of his duties as a farmer. Direct examination of corneal scrapings revealed fungus filaments. As topical treatment with natamycin and econazole and subsequent systemic ketoconazole therapy failed, a full thickness therapeutic keratoplasty was performed. Post-operative treatment with amphotericin B and clotrimazole combined with cyclosporine resulted in a complete cure. The residual corneal infiltration in the recipient cornea became clear in a week. The fungal isolate was initially identified as a Fusarium species, but later reidentified through the use of morphological characteristics and sequence analysis of the internal transcribed spacer region as N. vasinfecta. The latters is a Hypocrealean fungus not hitherto reported as a causative agent of keratomycosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aspergillosis / microbiology*
  • Aspergillosis / therapy
  • Corneal Ulcer / microbiology*
  • Corneal Ulcer / therapy
  • DNA, Fungal / genetics
  • DNA, Ribosomal Spacer / genetics
  • Eye Infections, Fungal / microbiology*
  • Eye Infections, Fungal / therapy
  • Humans
  • Hypocreales / cytology
  • Hypocreales / genetics
  • Hypocreales / isolation & purification*
  • Hypocreales / pathogenicity
  • Immunocompromised Host*
  • Male
  • Middle Aged

Substances

  • DNA, Fungal
  • DNA, Ribosomal Spacer