Acremonium keratitis in a patient with herpetic neurotrophic corneal disease

Abstract

ABSTRACT. Fungi belonging to the genus Acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremonium potronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin B was unsuccessful and the infection eventually resolved with penetrating keratoplasty.

SarocladiumandAcremoniuminfections: New faces of an old opportunistic fungus

“…38,41,[64][65][66][67] The use of contact lenses was another risk factor associated with this type of ocular infection, 68 although many of them had unknown origins. 43,64,69,70 Some of the symptoms and characteristics displayed by patients affected of Acremonium or Sarocladium keratitis included severe ocular pain, unclear vision, photophobia, ocular ulcers and/ or hypopyon. 38,41,43,70 Diagnosis was generally made following microscopic observation of corneal biopsies or scrapings and sample culturing on media such blood agar, Sabouraud dextrose agar, brain heart infusion, chocolate agar, thyoglycolate broth or eosine methylene agar.…”

“…43,64,69,70 Some of the symptoms and characteristics displayed by patients affected of Acremonium or Sarocladium keratitis included severe ocular pain, unclear vision, photophobia, ocular ulcers and/ or hypopyon. 38,41,43,70 Diagnosis was generally made following microscopic observation of corneal biopsies or scrapings and sample culturing on media such blood agar, Sabouraud dextrose agar, brain heart infusion, chocolate agar, thyoglycolate broth or eosine methylene agar. [63][64][65][66][67]70 Species identification in these cases was achieved on 7 occasions (A potronii, A strictum and A kiliense in 2 cases each, and A atrogriseum in another), 38,41,43,67,71,72 while the aetiological agents in the other cases were only reported as Cephalosporium sp.…”

“…63,65,66,[68][69][70] Treatments generally consisted of corneal transplant together with AMB treatment. 38,43,64,69 Alternatively,…”

Mycotic keratitis: an overview of diagnosis and therapy

“…Allescheria ) boydii , Sporothrix schenckii , Verticillium spp., Acremonium spp., Fusidium spp., Sterigmatocystis nigra , Paecilomyces lilacinus , Periconia keratitidis , Neurospora spp., Volutella spp., Glenospora spp., Penicillium spp., Penicillium citrinum , Penicillium spinulosum , Graphium spp., Fusarium solani , Fusarium nivale , Fusarium oxysporum, Candida albicans , Candida guilliermondii , Candida viswanathii , Candida krusei , Rhodotorula spp., Colletotrichum state of Glomerella cingulata , Acrophialophora fusispora , Phaeotrichoconis crotalariae , Helminthosporium , Neosartorya fischeri var. fischeri , Arthrobotrys oligospora , Trichophyton mentagrophytes , Epidermophyton floccosum 19–42 . Species of Aspergillus , Fusarium, and Candida have been found to be the most common agent.…”

Successful Treatment of Paecilomyces lilacinus Keratitis in a Patient With a History of Herpes Simplex Virus Keratitis

“…Other fungal organisms, including Acremonium sp., Candida sp., Aspergillus sp., and Scopulariopsis brevicaulis, have been implicated in secondary fungal keratitis in patients with HSV keratitis. [14][15][16][17] Presence of an epithelial defect and prolonged use of topical corticosteroids were the most common risk factors for developing a fungal superinfection. 16 Topical steroids are known to delay epithelial healing and to decrease mobilization of neutrophils.…”