Severe fungal sclerokeratitis caused by Metarhizium anisopliae: a case report and literature review

Mycoses. 2015 Feb;58(2):88-92. doi: 10.1111/myc.12279. Epub 2015 Jan 15.

Abstract

To date, there has been only one published report on the infectious sclerokeratitis caused by Metarhizium anisopliae, which is an entomopathogenic fungus. Regarding corneal infection, three reports have been published to date. Although the prognoses of the corneal infections are favourable, prognosis when scleral infection is involved is very poor. A 76-year-old patient presented with foreign body sensation in the left eye. Microscopic examination with Fungi Flora Y staining of the corneal scraping revealed fungal infection. The conjunctiva was melted by the infection over a wide area. Although intensive medications were administered, an emergency surgery was necessary because scleral thinning, corneal perforation and lens prolapse occurred. The fungal isolate was identified as M. anisopliae by sequencing the internal transcribed spacer region. Herein, we report the second known case worldwide of M. anisopliae sclerokeratitis, and we review the literature related to the ocular infections.

Keywords: Metarhizium anisopliae; ocular infections; sclerokeratitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Corneal Perforation / etiology
  • Diagnostic Errors
  • Echinocandins / pharmacology
  • Eye Infections, Fungal / microbiology*
  • Eye Infections, Fungal / therapy
  • Humans
  • Japan
  • Keratitis / microbiology*
  • Keratitis / therapy
  • Lipopeptides / pharmacology
  • Male
  • Metarhizium / drug effects
  • Metarhizium / isolation & purification*
  • Metarhizium / ultrastructure
  • Micafungin
  • Scleritis / microbiology*
  • Scleritis / therapy

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Micafungin