Optic atrophy due to Curvularia lunata mucocoele

Abstract

The authors report on the case of a 57-year-old male who presented with poor vision of his right eye. He had right optic nerve atrophy secondary to neural compression by a mucocoele in the pituitary fossa. The patient underwent transphenoidal resection of the mucocoele. Microbiology revealed Curvularia lunata and Enterobacter aerogenes present in the specimen. He was treated with liposomal Amphotericin B and meropenem. Assessment of vision post-operatively demonstrated improvement in his visual acuity. On reviewing the published literature, this case was found to be the first in which Curvularia had caused optic neuropathy. There have been only five previously documented reports of Curvularia causing CNS infections. This case demonstrates the importance of obtaining a tissue diagnosis together with appropriate surgical and medical management in the treatment of invasive fungal disease.

Brainstem phaeohyphomycosis due to Curvularia lunata (Cochliobolus lunatus) in a cat

“…In CT, focal intraparenchymal hypodensity within the forebrain with accompanying perilesional haemorrhage, oedema and midline shift has been described 28 . Pituitary fossa mucocele with associated optic nerve atrophy 29 and sellar mass that is uniformly contrast enhancing mimicking meningioma, 30 have been reported as uncommon localisations of the fungus. Destruction of the anterior cranial fossa floor in the CT 31 or nasal involvement with osseous erosion of the cribriform plate and medial walls of orbits 26 can accompany the main lesions.…”

Curvularia brain abscess

“…Carter and Boudreaux 7 reported a patient with a large basal ganglia lesion caused by C. lunata that was fatal within 1month. Smith et al 8 reported a patient with a pituitary fossa lesion resulting in optic nerve atrophy caused by C. lunata that was treated with stereotactic transphenoidal resection and antifungals without relapse up to 8 months follow-up. Singh et al 9 reported a patient with a cranial base lesion caused by C. geniculata treated with limited transnasal endoscopic debulking.…”

“…Curvularia is a common cause of allergic fungal sinusitis, 10 although there is only one report of a patient with associated cerebral Curvularia infection. 8 It is unclear why this ubiquitous organism causes invasive cerebral disease in rare instances.…”

Novel Inhibitors of Trihydroxynaphthalene Reductase with Antifungal Activity Identified by Ligand-Based and Structure-Based Virtual Screening

“…The plant diseases include leaf blight on Sorghum , leaf spot on Cannabis sativa , seedling blight on Saccharum spp, and stem necrotic lesions on Hylocereus polyrhizus . , By reviewing the published literature, we also found several case reports of C. lunata as the causative agent of diseases in both immunocompromised and immunocompetent individuals. Clinical manifestations of C. lunata infections include allergic fungal sinusitis, endocarditis, peritonitis, eumycetoma, keratitis, allergic bronchopulmonary disease, endophtalmitis, optic neuropathy, and disseminated phaeohyphomycosis. ,− The number of case reports on disseminated phaeohyphomycosis has increased in recent years, mostly, although not exclusively, in patients with iatrogenic immunodeficiency. There are limited therapeutic options for the treatment of these frequently fatal infections (overall mortality rate, 79%), and thus new antifungal agents and therapeutic options are urgently needed …”