A Case of Black Fungal Keratitis Caused by Biatriospora mackinnonii

Dematiaceous fungal keratitis caused by Cladophialophora boppii - A case report

Purpose

To report a rare case of dematiaceous fungal keratitis caused by Cladophialophora boppii (C. boppii) in an immunocompromised patient.

Observations

An 83-year-old male with chronic renal failure was referred to the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan due to persistent corneal epithelial defects (PEDs) in his left eye. Initial examination revealed decreased central corneal sensitivity and decreased tear secretion in that eye, both thought to be associated with herpetic keratitis. Permanent punctal-plug surgery combined with therapeutic soft contact lens wear was performed to treat the PED, which initially healed, yet recurred. Follow-up examination revealed a 1.0-mm-diameter black lesion consistent with the PED site, which subsequently increased in size, so treatment with miconazole solution eye drops, natamycin ophthalmic ointment, and systemic itraconazole was initially performed. Since the region of the lesion had progressed to corneal perforation, corneal transplantation surgery under general anesthesia was scheduled, yet the patient refused to undergo surgery. Mycological testing via DNA sequencing of the internal transcribed spacer of ribosomal DNA regions revealed that the isolate or pathogen was C. boppii. Mycotic keratitis caused by C. boppii was found to be resistant to antifungal drugs.

Conclusion and importance

This is a rare case of fungal keratitis caused by C. boppii in an elderly immunocompromised patient.

Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer

Purpose

Observations

Conclusions

A case of cutaneous phaeohyphomycosis caused by Biatriospora mackinnonii

Phaeohyphomycosis is a fungal infection common in immunocompromised patients such as those with hematologic malignancies, transplant recipients or under prolonged corticosteroid use. Here we describe a rare case of phaeohyphomycosis due to Biatriospora mackinnonii in a kidney transplant patient. We confirmed B. mackinnonii identity by sequencing of the internal transcribed spaces (ITS) region of ribosomal DNA (rDNA) and achieved a satisfactory therapeutic response with itraconazole administration.