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A case of rare fungal keratitis caused by Pseudoshiraia conidialis

Summary

A 61-year-old woman scratched her eye with a bamboo branch and developed a serious fungal eye infection caused by a rare fungus called Pseudoshiraia conidialis. This is the first reported case of this particular fungus infecting human eyes. Although initial treatment with antifungal medications showed promise, the infection proved difficult to cure due to the fungus being resistant to multiple antifungal drugs. The case highlights the importance of early diagnosis and treatment of fungal eye infections.

Background

Fungal keratitis is a highly destructive corneal infection typically caused by filamentous fungi such as Fusarium and Aspergillus. Pseudoshiraia conidialis is a filamentous fungus belonging to the Shiraiaceae family commonly found in living bamboo stalks, with no previous reports of human infections.

Objective

To report the first case of fungal keratitis caused by Pseudoshiraia conidialis in a patient who sustained bamboo branch eye trauma and to document clinical findings, diagnostic procedures, and treatment outcomes.

Results

The isolate was confirmed as Pseudoshiraia conidialis with 99.82% similarity to known strains. The strain showed resistance to itraconazole, amphotericin B, posaconazole, and voriconazole. Following corneal debridement and treatment with tropicamide eye drops and itraconazole, the patient showed significant early improvement but the infection was not cured and the patient was lost to follow-up.

Conclusion

This is the first reported case of keratitis caused by Pseudoshiraia conidialis. Microbial culture remains the gold standard for diagnosing fungal keratitis. Early intervention and appropriate antifungal therapy are essential, though drug resistance may limit treatment efficacy.
  • Published in:Medicine (Baltimore),
  • Study Type:Case Report,
  • Source: PMID: 40859553, DOI: 10.1097/MD.0000000000044001
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