Acrophialophora fusispora as an Agent of Mycotic Keratitis: A Case Report and Review of Literature.

BACKGROUND: Acrophialophora species is an infrequent human opportunistic pathogen. It is widely distributed in temperate as well as tropical regions. Here, we present a rare case of fungal keratitis caused by A. fusispora. CASE PRESENTATION: A 26-year male driver presented with pain, watering, redness, whitish discoloration, and blurring of vision in the left eye for the last 3-4 days. Upon examination, he had a dry-looking corneal ulcer with infiltration and satellite lesions. Corneal scrapings were positive for septate fungal hyphae by Gram staining and KOH mount. After five days, the growth observed was presumptively identified as genus Acrophialophora and finally identified as Acrophialophora fusispora by genetic sequencing. The patient failed to respond medically and was planned for therapeutic keratoplasty. DISCUSSION: To date, four cases of ocular involvement due to Acrophialophora have been described. Amongst which one case was associated with an immunocompromised state. Three of the cases were resolved medically, while one required therapeutic keratoplasty, indicating possible strong pathogenicity to the eye. CONCLUSION: As Acrophialophora seems to have a predilection for eye infections, an early diagnosis with timely appropriate treatment is the best way to restore the normal vision of a patient.