Alternaria fungal dacryocystitis with cutaneous fistula: a case report

ABSTRACT

Alternaria is a fungal genus that can cause opportunistic human infection in immunocompromised hosts. While the majority of clinical manifestations are cutaneous or subcutaneous infections, there are reports of oculomycosis, which is most commonly present as keratomycosis or endophthalmitis.Here, we present a rare case of Alternaria dacryocystitis with cutaneous fistula in a diabetic patient. The patient was referred with a non-healing medial canthal wound and an initial biopsy report showing “ruptured hair follicle;” re-examination of the biopsy specimen with fungal stains led to the diagnosis of alternariosis. The patient underwent surgical debridement and systemic antifungal treatment, with complete resolution of the infection. In order to initiate prompt treatment and prevent invasive disease, fungal infection should be considered in an immunocompromised patient with chronic dacryocystitis and cutaneous fistula or a nonhealing medial canthus wound.

KEYWORDS:

• Alternaria
• dacryocystitis
• lacrimal sac
• fungal infection
• immunocompromised

Disclosure statement

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

Meeting presentation

This work was presented as a poster at the American Society of Ophthalmic Plastic and Reconstructive Surgery Fall Symposium (2021).

Additional information

Funding

This work was supported in part by an Unrestricted Grant from Research to Prevent Blindness, Inc. to the UW-Madison Department of Ophthalmology and Visual Sciences.