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Fungal Keratitis Caused by Colletotrichum dematium: Case Study and Review

  • Vladimír Buchta
  • Jana Nekolová
  • Naďa Jirásková
  • Radka Bolehovská
  • Jan Wipler
  • Vit HubkaEmail author
Case Report
  • 31 Downloads

Abstract

Colletotrichum species are known as important pathogens of plants with an impact on crop production. Some of these species are also known as a cause of rare ophthalmic infections in humans. A case of keratitis caused by Colletotrichum dematium after corneal trauma in a 56-year-old woman is presented. Infection was diagnosed based on positive microscopy and culture. The fungal isolate was identified by morphological characteristics and DNA sequencing of the ITS rDNA region, β-tubulin (tub2) and glyceraldehyde-3-phosphate dehydrogenase (gapdh) genes. The patient responded well to topical therapy with amphotericin B combined with intravenous amphotericin B but improvement was associated with the corneal collagen cross-linking. The review of the literature revealed another 13 cases of C. dematium keratitis, all but one patient having at least one keratitis risk factor in their history. Almost all patients (n = 12) were treated with topical polyene antibiotics (natamycin or amphotericin B), improvement and cure were achieved in eight of them.

Keywords

Colletotrichum dematium Coelomycetous fungi Corneal collagen cross-linking Glomerella Keratomycosis Molecular identification Therapy 

Notes

Acknowledgements

This work was supported by the Charles University, Prague, Czech Republic (Project PROGRES Q40/07). The contribution of VH was supported by the Project BIOCEV (CZ.1.05/1.1.00/02.0109) provided by the Ministry of Education, Youth and Sports of CR and ERDF and Charles University Research Centre program No. 204069. We would like to thank Dr. Kateřina Nokd for providing clinical strain.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Clinical Microbiology, University Hospital and Faculty of Medicine Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
  2. 2.Eye Clinic, University Hospital and Faculty of Medicine Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
  3. 3.Department of Botany, Faculty of ScienceCharles UniversityPragueCzech Republic
  4. 4.Laboratory of Fungal Genetics and MetabolismInstitute of Microbiology of the Czech Academy of SciencesPragueCzech Republic

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