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Review
. 2015 Aug 19:15:106.
doi: 10.1186/s12886-015-0092-1.

Cladosporium keratitis - a case report and literature review

Steve Chih-Hsuan Cheng  1 , Ying-Yu Lin  2 , Chien-Neng Kuo  3   4 , Li-Ju Lai  5   6
Affiliations
Review

Cladosporium keratitis - a case report and literature review

Steve Chih-Hsuan Cheng et al. BMC Ophthalmol. .

Abstract

Background: Fungal keratitis is one of the major causes of infectious keratitis in tropical countries. Symptoms of fungal keratitis consist of blurred vision, redness, tearing, photophobia, pain and foreign body sensation. If not treated effectively, it could lead to blindness. Common causes include Candida spp., Fusarium spp. and Aspergillus spp.. With the limited choices of topical antifungal agents, we were faced with Cladosporium keratitis, a rare cause of fungal keratitis.

Case presentation: A 62-year-old Asian male construction worker came to us with intense ocular pain, injection of the conjunctiva, blurred vision, and foreign body sensation in his left eye. His visual acuity was 20/40 OD and 20/400 OS. Slit-lamp exam revealed a corneal ulcer with feathery margin and Descemet's membrane folding. The culture yielded Cladosporium species.. The patient did not show improvements after applying topical natamycin (5 %), topical amphotericin B (1mg/ml), topical fluconazole (2mg/ml) and oral ketoconazole (200mg). After shifting the medical regimen to voriconazole via topical and systemic routes (1mg/ml and 200mg respectively), the keratitis was controlled.

Conclusions: Fungal keratitis remains a challenge for ophthalmologists as there is no evidence suggesting any particular drug or combination of drugs is more effective than another. A review of common topical antifungal agents was done. Voriconazole could be a good choice for treating corneal infection by Cladosporium species.

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Figures

Fig. 1
Fig. 1
Fungal keratitis caused by Cladosporium sp. An external photograph of the left eye of a 62-year-old male construction worker with Cladosporium keratitis. This photograph was taken 4 days after trauma. The corneal ulcer was found with feathery margin and Descemet’s membrane folding. Ring infiltration was also present
Fig. 2
Fig. 2
Cladosporium keratitis 3 months after treatment. This external eye photograph was taken from the same patient three months after treatment. The patient’s left eye showed corneal opacity with minimal infiltration
See this image and copyright information in PMC

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