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Fungal Keratitis Caused by Humicola sardiniae

Summary

A 78-year-old man developed a serious fungal eye infection caused by Humicola sardiniae, a fungus rarely seen in humans. The infection was difficult to treat because the fungus was resistant to most antifungal medications, and continued use of steroid eye drops worsened the condition. After switching to appropriate antifungal treatment and stopping the steroids, the patient’s cornea eventually healed over four months, though this was the first documented case of this particular fungus infecting a human.

Background

Humicola is a fungal genus found in soil and plant debris that rarely causes human infections. This case report describes the first documented human infection caused by Humicola sardiniae, presenting as fungal keratitis in a patient receiving topical treatment for glaucoma.

Objective

To report and characterize the first documented case of fungal keratitis caused by Humicola sardiniae in a human patient, including morphological identification and antifungal susceptibility testing.

Results

The fungal isolate was identified as Humicola sardiniae based on morphological characteristics and genetic sequencing showing 99.2% and 99.7% homology to the ex-type strain. Antifungal susceptibility testing showed resistance to nearly all tested agents including amphotericin B, voriconazole, and itraconazole. Complete corneal re-epithelialization was achieved 8 weeks after initial presentation, with cure taking four months from initiating antifungal treatment.

Conclusion

This is the first reported case of Humicola sardiniae infection in humans, demonstrating its potential pathogenic capability. The isolate exhibited broad antifungal resistance, highlighting the challenge in treating infections caused by this species and the importance of early diagnosis and appropriate management.
  • Published in:Mycopathologia,
  • Study Type:Case Report,
  • Source: PMID: 39714623, DOI: 10.1007/s11046-024-00913-7
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