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Fusarium Corneal Abscess: A Case Report

Summary

A 20-year-old healthy patient developed a serious fungal eye infection caused by Fusarium, a common soil fungus, despite having no typical risk factors like eye trauma or contact lens wear. The infection created an abscess (collection of pus) in the cornea and threatened the patient’s vision. Doctors used a combination of antifungal medications and eventually transplanted amniotic membrane tissue to prevent the cornea from rupturing, preserving the patient’s eyesight.

Background

Fusarium is a cosmopolitan fungus that causes serious eye infections threatening functional prognosis. Fusarium keratitis is the most severe form of mycotic keratitis, accounting for up to 47% of fungal keratitis cases in tropical and subtropical regions. The infection typically follows trauma or contact lens use, though rare cases in immunocompetent patients without risk factors are underreported.

Objective

To report and discuss the case of a Fusarium corneal abscess in a healthy young adult with no identifiable risk factors. The objective is to highlight clinical suspicion required for atypical presentations and therapeutic considerations in managing severe fungal keratitis.

Results

Fusarium moniliforme was identified on direct examination and confirmed by culture showing characteristic whitish downy colonies after 72 hours. Initial treatment with topical voriconazole eye drops showed limited improvement, but intrastromal voriconazole injections combined with amniotic membrane grafting prevented corneal perforation. Follow-up showed epithelial healing with scar formation and stable intraocular pressure.

Conclusion

Fusarium can infect structurally healthy corneas in immunocompetent individuals, a rare presentation requiring early diagnostic vigilance. Combination therapy with natamycin and voriconazole offers enhanced efficacy against this highly resistant organism. Amniotic membrane transplantation may be necessary to preserve functional prognosis when medical therapy alone proves insufficient.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 41111792, DOI: 10.7759/cureus.92523
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