Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Apr 27;11(2):190-192.
doi: 10.4103/tjo.tjo_17_19. eCollection 2021 Apr-Jun.

Alternaria chartarum sclerokeratouveitis: A new fungus cause

Luz Elena Concha Del Río  1 , Carolina Ramirez-Dominguez  1 , Virginia Vanzzini-Zago  1 , Lourdes Arellanes-Garcia  2
Affiliations
Case Reports

Alternaria chartarum sclerokeratouveitis: A new fungus cause

Luz Elena Concha Del Río et al. Taiwan J Ophthalmol. .

Abstract

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.

Keywords: Alternaria chartarum; fungus; sclerokeratouveitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no conflicts of interests of this paper.

Figures

Figure 1
Figure 1
(a) Slit-lamp photograph showing diffuse hyperemia, ciliary injection, corneal edema, hypopyon, and nasal scleral calcified plaque with necrosis. (b) Slit-lamp photograph showing an increase in hypopyon and scleral thinning surrounding the calcified plaque
Figure 2
Figure 2
(a) Hyphae in the sclera (arrow) (Grocott-Gomori's stain ×40). (b) Alternate septated hyphae (lactophenol cotton blue wet mount ×400
See this image and copyright information in PMC

References

    1. Hodson KL, Galor A, Karp CL, Davis JL, Albini TA, Perez VL, et al. Epidemiology and visual outcomes in patients with infectious scleritis. Cornea. 2013;32:466–72. - PubMed
    1. Ho YF, Yeh LK, Tan HY, Chen HC, Chen YF, Lin HC, et al. Infectious scleritis in Taiwan-a 10-year review in a tertiary-care hospital. Cornea. 2014;33:838–43. - PubMed
    1. Ramenaden ER, Raiji VR. Clinical characteristics and visual outcomes in infectious scleritis: A review. Clin Ophthalmol. 2013;7:2113–22. - PMC - PubMed
    1. Tittler EH, Nguyen P, Rue KS, Vasconcelos-Santos DV, Song JC, Irvine JA, et al. Early surgical debridement in the management of infectious scleritis after pterygium excision. J Ophthalmic Inflamm Infect. 2012;2:81–7. - PMC - PubMed
    1. Pujol I, Aguilar C, Gené J, Guarro J. In vitro antifungal susceptibility of Alternaria spp.and Ulocladium spp. J Antimicrob Chemother. 2000;46:337. - PubMed

Publication types