Open AccessAlternaria chartarum sclerokeratouveitis: A new fungus cause
Author(s) -
Luz Elena Concha del Río,
Carolina Ramirez-Dominguez,
Virginia Vanzzini-Zago,
Lourdes Arellanes-García
Publication year - 2021
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.4103/tjo.tjo_17_19
Subject(s) - medicine , voriconazole , fungus , fungal keratitis , hypopyon , microbiology and biotechnology , ophthalmology , dermatology , surgery , cornea , visual acuity , antifungal , botany , biology
We report a case of Alternaria chartarum sclerokeratouveitis with an unfavorable response to treatment. To the best of our knowledge, there are no previous reports of this fungus invading the sclera. A 68-year-old diabetic farmer male patient presented with a 3-week history of pain and redness and a decrease in visual acuity occurring 5 days before admittance in the right eye. Examination revealed severe mixed hyperemia and a scleral calcified plaque with a surrounding area of ischemia and lysis. The cornea showed diffuse infiltrates, stromal edema, and hypopyon. Initial scrapings were negative, and empiric antibiotics were started. After a fungus was reported, topical and systemic antifungals were initiated, but there was no clinical response. The eye was enucleated. A slow-growing fungus A. chartarum , resistant to voriconazole, was isolated. Fungal etiology must be kept in mind when dealing with infectious scleritis. Despite treatment, the outcome of this case was unfavorable due to the slow-growing nature of the fungus and this strain's resistance to voriconazole.