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Fusarium Corneal Abscess: A Case Report

Summary

A healthy 20-year-old man developed a serious fungal eye infection caused by Fusarium, a soil fungus, despite having no typical risk factors like eye injury or contact lens wear. Doctors diagnosed the infection through laboratory tests showing fungal filaments and growing the organism in culture. The patient required multiple treatments including antifungal eye drops, injections directly into the cornea, and a graft from amniotic membrane (placenta tissue) to save his vision. The case demonstrates that fungal eye infections can occasionally occur in completely healthy people without obvious causes.

Background

Fusarium is a cosmopolitan fungus that causes serious eye infections threatening functional prognosis. Fusarium keratitis is the most severe form of fungal corneal infection, accounting for up to 47% of fungal keratitis cases in tropical and subtropical regions. While typically associated with corneal trauma or contact lens use, atypical presentations without known risk factors remain underreported.

Objective

To report an unusual case of Fusarium corneal abscess in a healthy, immunocompetent individual with no identifiable risk factors or prior corneal pathology. To highlight the clinical suspicion required and therapeutic considerations in atypical presentations of Fusarium keratitis.

Results

Direct microscopy revealed mycelial filaments. Culture on Sabouraud agar showed whitish downy colonies at 72 hours, identifying Fusarium moniliforme. Treatment included hourly voriconazole and ceftazidime eye drops, intrastromal voriconazole injections, and amniotic membrane grafting. The patient achieved epithelial healing with scar formation and stable intraocular pressure of 18 mmHg.

Conclusion

Fusarium can occasionally infect structurally healthy corneas in immunocompetent individuals, representing a rare atypical presentation. Early diagnostic vigilance is essential even without conventional risk factors. Combined natamycin and voriconazole therapy with amniotic membrane grafting when needed offers enhanced efficacy against this highly resistant organism.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 41111792, DOI: 10.7759/cureus.92523
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