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Colletotrichum keratitis: A rare yet important fungal infection of human eyes
Author(s) -
Hung Ning,
Hsiao ChingHsi,
Yang ChingSheng,
Lin HsinChiung,
Yeh LungKun,
Fan YunChen,
Sun PeiLun
Publication year - 2020
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13058
Subject(s) - fungal keratitis , keratitis , colletotrichum , phylogenetic tree , biology , internal transcribed spacer , ribosomal dna , intergenic region , colletotrichum gloeosporioides , medicine , dermatology , botany , genetics , gene , genome
Summary Background Colletotrichum is a rare cause of human infection. Previous reports about Colletotrichum keratitis were limited, and most diagnoses from past reports were based on morphological distinction, which could have led to underestimation of the prevalence of Colletotrichum species. Objective We reported phylogenetic analysis, clinical feature and treatment outcome of molecularly diagnosed Colletotrichum keratitis in our hospital. Patients/Methods We recruited 65 patients with culture‐proven filamentous fungal keratitis between January 1, 2015 and December 30, 2018. Through molecular sequencing including internal transcribed spacer (ITS) and multi‐locus phylogenetic analysis of fungal DNA, seven patients were verified as infected with Colletotrichum species, and their medical records were reviewed to determine the clinical characteristics. Results Six of seven patients had predisposing factors including trauma (5) and immunosuppressive status (1). Six isolates were initially misidentified as other fungi through morphological identification. ITS sequencing identified the isolates belonged to two species complex (SC): C. truncatum and C. gloeosporioides; multi‐locus phylogenetic analysis enabled species identification including C. tropicale (3) , C. fructicola (2) , C. truncatum (1) and C. fusiforme (1) . Five patients with C. gloeosporioides SC responded well to medical treatment and two patients with C truncatum SC underwent evisceration because of either no visual potential or intractable pain. Conclusions The molecular approach provides accurate diagnosis and raises epidemiological awareness of Colletotrichum keratitis. Through multi‐locus phylogenetic analysis, we report the human infections caused by C. tropicale, C. fructicola and C. fusiforme . We also highlight the different clinical outcomes between C. gloeosporioides SC and C. truncatum SC.