Bellanda Victor F, See Craig W
Ribeirão Preto Medical School, University of São Paulo, 3900 Bandeirantes Ave, Ribeirão Preto, ZIP 14049-900, SP, Brazil.
Cole Eye Institute, Cleveland Clinic, 2022 East 105th Street, Cleveland, OH, ZIP 44106, USA.
Am J Ophthalmol Case Rep. 2023 Sep 23;32:101930. doi: 10.1016/j.ajoc.2023.101930. eCollection 2023 Dec.
To report a case of fungal keratitis caused by Coniochaeta mutabilis along with its treatment and discuss the possibility of an unusual mode of transmission. Only a few cases of ocular C. mutabilis infection have been reported, and this is the first presenting domestic fowl as a potential source of infection.
A 52-year-old woman presented with a corneal ulcer following a week of increasing eye pain. Five months prior, she had a corneal abrasion in the same eye that resulted from trauma during yard work. Two weeks before presentation, she cared for a chicken with ocular infection. Culture of the corneal scraping identified , a rarely described fungal pathogen. After multiple treatment modalities were attempted, the patient ultimately underwent penetrating keratoplasty. No signs of infection recurrence were present during follow-up after the procedure.
keratitis is a rare condition that typically presents with an aggressive nature and requires multiple forms of treatment. Here, we report direct contact with an infected chicken cornea as a possible mode through which the disease was acquired. Early suspicion of fungal etiology in cases of keratitis allows directed treatment, which may improve visual outcomes. Acknowledging unusual modes of transmission may help bring this differential diagnosis into consideration. Furthermore, given the scarcity of literature about this disease, individual case reports are informative for guiding future treatment and research.
报告一例由多变附球菌引起的真菌性角膜炎病例及其治疗情况，并探讨一种不寻常传播方式的可能性。仅报告了少数几例眼部多变附球菌感染病例，而这是首例提出家禽作为潜在感染源的病例。
一名52岁女性在眼部疼痛加剧一周后出现角膜溃疡。五个月前，她在庭院劳作时同一眼因外伤导致角膜擦伤。就诊前两周，她照料了一只患有眼部感染的鸡。角膜刮片培养鉴定出一种很少被描述的真菌病原体。在尝试了多种治疗方式后，患者最终接受了穿透性角膜移植术。术后随访期间未出现感染复发迹象。
真菌性角膜炎是一种罕见疾病，通常具有侵袭性，需要多种治疗形式。在此，我们报告与感染鸡角膜的直接接触可能是获得该疾病的一种途径。在角膜炎病例中早期怀疑真菌病因可进行针对性治疗，这可能改善视觉预后。认识到不寻常的传播方式可能有助于考虑这种鉴别诊断。此外，鉴于关于该疾病的文献稀缺，个案报告对指导未来治疗和研究具有参考价值。
