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Ocular Immunology and Inflammation Volume 31, 2023 - Issue 4
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Letters to the Editor

Post-traumatic Fungal Keratitis and Endophthalmitis Caused by Coniochaeta Hoffmannii with Late Recurrence following Therapeutic Full-thickness Penetrating Keratoplasty

Waleed Alsarhania Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON, Canada;b Department of Ophthalmology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-4596-735XView further author information
, MD, FICOORCID Icon,
Philip W. Lamc Department of Medicine, University of Toronto, Toronto, ON, Canada;d Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, CanadaView further author information
, BScPhm, MD, MSc, FRCPC,
Julianne V. Kuse Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;f Public Health Ontario, Toronto, ON, CanadaView further author information
, MSc, PhD, FCCM,
Corwyn Rowselle Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;g Department of Laboratory Medicine, St. Michael’s Hospital, Unity Health, Toronto, ON, CanadaView further author information
, MD, FRCPC, FCAP,
George Kar Tsuif Public Health Ontario, Toronto, ON, CanadaView further author information
, BSc, ART,
Manal Tadrose Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;h Department of Laboratory Medicine, Hospital for Sick Children, Toronto, ON, CanadaView further author information
, MBBS, MSc, PhD, FRCPC,
Ramzi Fattouhe Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;g Department of Laboratory Medicine, St. Michael’s Hospital, Unity Health, Toronto, ON, CanadaView further author information
, PhD, FCCM,
Yeni Yucela Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON, Canada;e Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;g Department of Laboratory Medicine, St. Michael’s Hospital, Unity Health, Toronto, ON, CanadaView further author information
, MD, PhD, FRCPC,
Peter J. Kertesa Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON, Canada;i Department of Ophthalmology & Vision Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0002-0348-5096View further author information
, MD, CM, FRCSCORCID Icon &
Hall F. Chewa Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON, Canada;i Department of Ophthalmology & Vision Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, CanadaView further author information
, MD, FRCSC show all
Pages 826-829 | Received 18 Nov 2021, Accepted 15 Feb 2022, Published online: 11 Apr 2022
 
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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.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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