Zhao Zixiang, Leng Siyu, Zou Yuhao, Xiang Lijuan, Li Yunke, Liu Yi, Wang Chongyang, Yu Man
Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Eye School of Chengdu, University of TCM, Chengdu, China.
J Ophthalmic Inflamm Infect. 2025 May 27;15(1):46. doi: 10.1186/s12348-025-00505-6.
Filamentous fungi are among the emerging causes of infections, although corneal infections caused by these fungi are rare, they can lead to severe clinical outcomes. In this report, we present the first documented case of keratitis caused by Stemphylium lycopersici, a filamentous hemipteran fungus of the Pleosporaceae family. A 66-year-old man presented conjunctival redness, irritation, and visual deterioration in his left eye, following a stone chip injury that occurred five months earlier. Despite multiple treatments, the causative pathogen remained unidentified, leading to worsening symptoms and significant vision loss. This deterioration led the patient to seek care at our hospital. An in vivo confocal microscopy (IVCM) examination suggested a fungal infection. Consequently, antifungal medications were administered, but the condition did not improve. Metagenomic next-generation sequencing (mNGS) examination of corneal scrapings revealed a mixed infection with S. lycopersici and human alphaherpesvirus 1. This definitive diagnosis facilitated the implementation of targeted therapy, leading to progressive symptomatic improvement. Early and rapid pathogen identification using mNGS analysis of corneal scrapings enables accurate management of infectious keratitis, contributing to visual recovery and reducing the risk of resistance to corneal pathogenic microbes.
丝状真菌是新出现的感染病因之一，尽管这些真菌引起的角膜感染很少见，但可能导致严重的临床后果。在本报告中，我们介绍了首例由番茄匍柄霉引起的角膜炎病例，番茄匍柄霉是格孢腔菌科的一种丝状半翅目真菌。一名66岁男性在5个月前发生石屑损伤后，左眼出现结膜充血、刺激感和视力下降。尽管进行了多种治疗，但致病病原体仍未明确，导致症状恶化和严重视力丧失。这种恶化促使患者到我院就诊。活体共聚焦显微镜检查提示真菌感染。因此，给予了抗真菌药物治疗，但病情并未改善。角膜刮片的宏基因组下一代测序（mNGS）检查显示番茄匍柄霉和人α疱疹病毒1混合感染。这一明确诊断有助于实施针对性治疗，使症状逐渐改善。使用角膜刮片的mNGS分析进行早期和快速病原体鉴定，能够准确管理感染性角膜炎，有助于视力恢复并降低角膜致病微生物产生耐药性的风险。
