Purpose: The aim of this study was to report a rare case of fungal keratitis from Eastern India.
Methods: This is a case report.
Results: A 52-year-old man with a history of minor trauma presented with a total corneal ulcer and hypopyon in the left eye. Microbiologic examination of corneal scrapings showed yeast cells in direct smear and typical yeast colonies on multiple solid agar media. Identification of the organism isolated in the culture was performed using the D1/D2 region of the large subunit (LSU 28S rDNA)–based molecular technique. Polymerase chain reaction amplified a band with a sequence that was 100% homologous with that of Candida fermentati. The organism was susceptible to amphotericin B and anidulafungin and demonstrated resistance to voriconazole, itraconazole, and fluconazole. Therapeutic keratoplasty was performed, followed by the recurrence of the infection in the graft, which was controlled with topical and intracameral amphotericin B. At the end of 3 months, the affected eye had developed phthisis bulbi.
Conclusions: This is the first report of isolation of C. fermentati, a species closely related to Candida guilliermondii, from keratitis. Molecular diagnostic techniques are helpful in the accurate identification of this organism, which is clinically important in view of an antifungal susceptibility pattern that differs from that of other yeasts and for selection of appropriate therapy.
Cornea Services (J.S., A.K.), Ocular Microbiology Services (S.S.), Pediatric Ophthalmology Services (A.G.), Priyamvada Birla Aravind Eye Hospital, Kolkata, India; and Department of Botany and Forestry (D.B.), Vidyasagar, University, Midnapore, West Bengal, India.
Address correspondence and reprint requests to Jayangshu Sengupta, M.S., Priyamvada Birla Aravind Eye Hospital, 10 Loudon Street, Kolkata 700017, India; e-mail: firstname.lastname@example.org
The authors have no funding or conflicts of interest to disclose.
Accepted March 10, 2012