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2016 Agenda and Abstracts | Next > 2016 OMIG Abstract 1 Magnusiomyces Capitatus Associated Fungal Keratitis: A Case Report of an Emerging Fungal Pathogen Purpose: The purpose of this paper is to describe a unique case of a female patient that was treated for a refractory fungal keratitis caused by Magnusiomyces capitatus, a fungus not previously associated with ophthalmic morbidity. Methods: A 71-year-old immunocompetant patient developed an infectious infiltrate in the left eye, presumed to be fungal in origin due to its clinical presentation and chronicity of its nature. Cultures were obtained on several occasions, but all were negative. Topical and systemic voriconazole showed modest improvement, however a penetrating keratoplasty was ultimately performed. Host cornea pathology demonstrated fungal elements, but cultures again were negative. Approximately 2 weeks after corneal transplant, the patient presented with a recurrent dense, deep corneal endothelial infiltrate with hypopion and fungal balls in the anterior chamber. B-scan ultrasound did not find vitreous inflammation. Despite intracameral injection of voriconazole, and concurrent systemic and topical treatment, there was minimal improvement. The patient ultimately underwent an anterior chamber washout with injection of intracameral amphotericin B. Cultures of the aqueous grew Magnusciomyces capitatus. The patient’s clinical course improved, however her graft failed and required repeat corneal transplant. Results: Magnusiomyces capitatus is a hyphomycetes that is a common commensal component of human skin flora and sputum. Its pathogenicity has been described in immunosuppressed patients in the form on pulmonary infections, systemic fungaemia, and endocarditis. Morphologically, it consists of fast growing, flat, white colonies with acute angled hyphae and abundant conidia formation. This appears to be the first case of culture positive Magnusiomyces infectious keratitis. Conclusion: Magnusiomyces capitatus is a newly emerging fungus that can cause rapid, destructive infectious keratitis that is often refractory to pharmacologic treatment and may require surgical intervention. Disclosures: N 2016 Agenda and Abstracts | Next >
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