Abstract

PURPOSE: To report a challenging case of fungal keratitis
METHODS: Case review
RESULTS: A 55-year-old female symptomatic for 1 month presented with a right eye(RE) deep corneal ulcer. RE diagnostic endoscraping was done, which revealed no organisms. Fortified empirical antibiotics were started. Anterior chamber (AC) wash was done three times for more than half of the AC hypopyon along with repeat corneal scrapings intraoperatively. After 2 weeks she underwent RE therapeutic penetrating keratoplasty with a donor graft of 11.5 mm due to failed medical management. The culture of the half-corneal button revealed a fungus (identified as Fusarium solani). After six months, she had a best-corrected visual acuity of 20/100 with a clear graft and cataractous lens.
CONCLUSION: Fusarium keratitis can be associated with poorer outcomes in cases of deep stromal keratitis with endo exudates and negative microbiology on repeated corneal scraping if early surgical intervention is not considered.