Breaking the mold: a case of recalcitrant eyelid subconjunctival infection by Exophilia Phaeomuriformis

ABSTRACT

While a rare ophthalmic pathogen, infections from Exophilia spp. are increasingly identified and have been associated with catastrophic vision loss. In this case report we present a previously undescribed manifestation of the melanin-producing fungus Exophilia Phaeomuriformis to the lower eyelid, establish an effective treatment, and review related cases. Previous cases of ophthalmic E. Phaeomuriformis were confined to the cornea and included iatrogenic tissue trauma. This case shares neither associations however includes a remote SJS history that likely led to changes in conjunctival tissue integrity. Previous cases of Exophilia spp. infecting the eyelid both included surgical source control and adjuvant antibiotic. In this case, topical therapy was deferred due to SJS-related ocular cicatricial disease. Fortunately, a full resolution was achieved with surgical resection and oral antifungal treatment.

KEYWORDS:

• Exophilia
• exophilia phaeomuriformis
• melanin-producing fungi
• mycetoma
• phaeohyphomycosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Presentation

The following research has not been presented previously presented at a conference.

Proprietary interest statement

The authors have no financial or conflicts of interest disclosures.

Additional information

Funding

EL is the endowed James L. Hargiss, M.D., Ophthalmic Plastic and Reconstructive Surgery Fellow and the Rayment Endowed Fellow in Ophthalmology.