Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer
Purpose: Pyrenochaeta unguis-hominis (syn. Neocucurbitaria unguis-hominis) is a rare fungal species belonging to the Coelomycetes group, mostly isolated from infected nails and skin.We present a case of contact lens-related fungal keratitis caused by Pyrenochaeta unguis-hominis. Observations: We pre...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993622004777 |
| _version_ | 1811185446404751360 |
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| author | Sima Nissan Jerina Boelens Katrien Lagrou Dimitri Roels |
| author_facet | Sima Nissan Jerina Boelens Katrien Lagrou Dimitri Roels |
| author_sort | Sima Nissan |
| collection | DOAJ |
| description | Purpose: Pyrenochaeta unguis-hominis (syn. Neocucurbitaria unguis-hominis) is a rare fungal species belonging to the Coelomycetes group, mostly isolated from infected nails and skin.We present a case of contact lens-related fungal keratitis caused by Pyrenochaeta unguis-hominis. Observations: We present a case of a 69-year-old woman with multiple risk factors for a fungal keratitis including ophthalmological history of herpetic keratitis, contact lens wear and chronic steroid use. At presentation, the corneal ulcer resembled a recurrent herpetic keratitis but evolved into a more dense stromal infiltrate despite antiviral therapy. Microscopic examination, culture and staining of corneal tissue obtained by scraping showed mycelia. PCR and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry confirmed the presence of Pyrenochaeta unguis-hominis. Topical antifungal treatment was able to dim the inflammation. Because of a persistent epithelial defect, an amniotic membrane transplantation was performed. Although corneal epithelium was restored, stromal scarring in the visual axis resulted in substantial vision loss. Conclusions: To our knowledge no other cases of fungal keratitis caused by Pyrenochaeta unguis-hominis have been described. Early diagnosis can allow prompt initiation of antifungal treatment, which should be guided by in vitro susceptibility testing. |
| first_indexed | 2024-04-11T13:30:46Z |
| format | Article |
| id | doaj.art-219a8d24e95c43829d72d29aa83f62ba |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-04-11T13:30:46Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-219a8d24e95c43829d72d29aa83f62ba2022-12-22T04:21:50ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-12-0128101731Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearerSima Nissan0Jerina Boelens1Katrien Lagrou2Dimitri Roels3Department of Ophthalmology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Corresponding author.Department of Clinical Biology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Herestraat 49, 3000, Leuven, Belgium; National Reference Centre for Mycosis, Department of Laboratory Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Ophthalmology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, BelgiumPurpose: Pyrenochaeta unguis-hominis (syn. Neocucurbitaria unguis-hominis) is a rare fungal species belonging to the Coelomycetes group, mostly isolated from infected nails and skin.We present a case of contact lens-related fungal keratitis caused by Pyrenochaeta unguis-hominis. Observations: We present a case of a 69-year-old woman with multiple risk factors for a fungal keratitis including ophthalmological history of herpetic keratitis, contact lens wear and chronic steroid use. At presentation, the corneal ulcer resembled a recurrent herpetic keratitis but evolved into a more dense stromal infiltrate despite antiviral therapy. Microscopic examination, culture and staining of corneal tissue obtained by scraping showed mycelia. PCR and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry confirmed the presence of Pyrenochaeta unguis-hominis. Topical antifungal treatment was able to dim the inflammation. Because of a persistent epithelial defect, an amniotic membrane transplantation was performed. Although corneal epithelium was restored, stromal scarring in the visual axis resulted in substantial vision loss. Conclusions: To our knowledge no other cases of fungal keratitis caused by Pyrenochaeta unguis-hominis have been described. Early diagnosis can allow prompt initiation of antifungal treatment, which should be guided by in vitro susceptibility testing.http://www.sciencedirect.com/science/article/pii/S2451993622004777Fungal keratitisPyrenocheata unguis-HominisAmphotericin BVoriconazole |
| spellingShingle | Sima Nissan Jerina Boelens Katrien Lagrou Dimitri Roels Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer American Journal of Ophthalmology Case Reports Fungal keratitis Pyrenocheata unguis-Hominis Amphotericin B Voriconazole |
| title | Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer |
| title_full | Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer |
| title_fullStr | Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer |
| title_full_unstemmed | Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer |
| title_short | Pyrenocheata unguis-hominis: A new cause of fungal keratitis in a contact lens wearer |
| title_sort | pyrenocheata unguis hominis a new cause of fungal keratitis in a contact lens wearer |
| topic | Fungal keratitis Pyrenocheata unguis-Hominis Amphotericin B Voriconazole |
| url | http://www.sciencedirect.com/science/article/pii/S2451993622004777 |
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