ABSTRACT
Background
To report a rare case of fungal keratitis and endophthalmitis due to Coniochaeta hoffmannii.
Methods
Case report.
Results
A 71-year-old immunocompetent male sustained a corneal laceration, traumatic cataract, and retinal detachment due to penetrating injury from a nail pulled from a wooden deck. The patient’s postoperative course was complicated by infectious keratitis. Fungal cultures, DNA sequencing and analysis of the internal transcribed spacer sequence confirmed Coniochaeta hoffmannii. Topical and oral voriconazole treatments were initiated; however, due to impending perforation, a therapeutic corneal transplant was required. One year later, the patient developed a new corneal infiltrate at the graft-host junction: Corneal scrapings were culture positive for Coniochaeta hoffmannii. This was treated with topical and intrastromal voriconazole along with oral itraconazole 200 mg once daily for 8 months.
Conclusions
Coniochaeta hoffmannii may cause recalcitrant keratitis and endophthalmitis, which required longstanding antifungal treatment.
Disclosure statement
Disclosure for Peter J. Kertes; Advisory board – Novartis, Bayer, Roche, Novelty Nobility, Appelis, AbbVie; Financial support (to institution) – Bayer, Roche, Novartis; Financial support – Novartis, Bayer, Pfizer, Boehringer Ingelheim; Equity owner – ArcticDx.
Informed consent
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the consent form is available for review by the Editor of this journal. Since this was a case report, an institutional review board approval was not required.