Jacobs Journal of Clinical Case Reports

Corneal Ulcer Due to the Fungus Lasiodiplodia theobromae in an Ecuadorian Farmer

*Jeannete Zurita
Department Of Case Reports, United States

*Corresponding Author:
Jeannete Zurita
Department Of Case Reports, United States
Email:jzurita@zuritalaboratorios.com

Published on: 2017-11-22

Abstract

We describe a case of a corneal ulcer as a result of traumatic implantation caused by the fungus Lasiodiplodia theobromae. It was isolated from a corneal lesion in a 35-year-old farmer in Puerto Quito (tropical forest of Ecuador). After a month of incubation, no sporulation was observed; the isolate was identified by DNA sequencing. The initial treatment with topic and intrastromal voriconazole failed. The patient was treated by conjunctival flap covering surgery and needs a corneal transplant.

Keywords

Corneal Ulcer; Ecuador; Fungal Keratitis; Lasiodiplodia theobromae

Introduction

Microbial keratitis remains the fifth cause of blindness worldwide [1], with 6% to 60% of cases involving fungal species [2]. These infections are more prevalent in tropical and subtropical regions of low and middle-income countries and are related to agricultural activities [1,2]. The corneal abrasion after an ocular trauma often occurs prior to the acquisition of infection, but other risk factors of fungal keratitis stems from the use of contact lenses and ocular surface diseases [1-3]. Environmental filamentous fungi, including Fusarium spp. and Aspergillus spp., are the most frequent etiological agents. However, other species of fungi could cause human keratitis [2]. Lasiodiplodia theobromae is a pleomorphic ascomycete that is mostly distributed in tropical and subtropical areas [4]. This fungus is a plant pathogen but has unfrequently been involved in human mycosis. Fungal keratitis has rarely been described as a cause of mycotic keratitis with approximately 6% of cases [1,2]. Nevertheless, the prevalence of keratitis caused by L. theobromae remains largely unknown and mostly based on information from case reports [1, 2, 5]. In this case, we described a fungal keratitis caused by L. theobromae in Ecuador and compared the results with previous reports.