Identification problems with sterile fungi, illustrated by a keratitis due to a non-sporulating Chaetomium-like species

Med Mycol. 2012 May;50(4):361-7. doi: 10.3109/13693786.2011.611179. Epub 2011 Sep 28.

Abstract

A 39-year-old farm worker was injured in her right eye by a piece of wire, which resulted in a corneal ulcer unresponsive to antibiotic treatment. The clinical appearance was that of a corneal infiltrate with feathery borders resembling fungal keratitis. Corneal scrapings were collected and the patient was started on natamycin 5% eye drops, fluconazole 0.3% eye drops, and oral fluconazole. A non-sporulating fungus was isolated from the samples. Based upon macroscopic and microscopic morphologic features, it was provisionally identified as a Papulaspora species due to the fact that members of this genus generally do not form diagnostically useful conidia. However, it was found through the use of ITS sequencing that the isolate clustered within the ascomycete genus Chaetomium. The sequence did not fully match with any sequences of available ex-type strains of Chaetomium, Thielavia and Papulaspora and hence might belong to an undescribed specie. However, without diagnostic morphological features the taxon cannot be introduced as a novel member of the genus Chaetomium. Antifungal susceptibility testing was performed according to published standards. The corneal ulcer was successfully treated with six weeks of antifungal therapy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antifungal Agents / administration & dosage
  • Chaetomium / classification*
  • Chaetomium / isolation & purification*
  • Cluster Analysis
  • Corneal Injuries
  • DNA, Fungal / chemistry
  • DNA, Fungal / genetics
  • DNA, Ribosomal Spacer / chemistry
  • DNA, Ribosomal Spacer / genetics
  • Female
  • Humans
  • Keratitis / diagnosis*
  • Keratitis / drug therapy
  • Keratitis / microbiology*
  • Keratitis / pathology
  • Molecular Sequence Data
  • Mycology / methods
  • Mycoses / diagnosis*
  • Mycoses / drug therapy
  • Mycoses / microbiology*
  • Mycoses / pathology
  • Phylogeny
  • Sequence Analysis, DNA
  • Wounds and Injuries / complications

Substances

  • Antifungal Agents
  • DNA, Fungal
  • DNA, Ribosomal Spacer

Associated data

  • GENBANK/HQ906667