Ocular Microbiology and Immunology Group
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2017 OMIG Abstract 22

Candida dubliniensis: A Novel Cause of Fungal Keratitis

Tyler D. Oostra, MD and Thomas F. Mauger, MD
Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center, Columbus, Ohio

Purpose:  The purpose of this case report is to describe a case of infectious keratitis due to Candida dubliniensis.  This organism has been described in endophthalmitis, but this is the first reported case of fungal keratitis to our knowledge.

Methods:  A case of C. dubliniensis fungal keratitis was diagnosed by culture and corneal pathology.

Results:  A 45-year-old female with history of contact lens wear presented with eye pain, redness, and decreased vision for 2 months and a persistent corneal ulcer that was unresponsive to topical moxifloxacin.  The patient’s exam was concerning for fungal keratitis.  Cultures were obtained, and the patient was started on fortified amphotericin B drops and oral voriconazole.  The cultures identified C. dubliniensis as the causative organism.  The patient’s exam worsened despite treatment, and the decision was made for surgery.  At the time of surgery, her cornea was found to have unexpectedly perforated.  She underwent cryo therapy; tectonic penetrating keratoplasty; anterior chamber tap; intracameral voriconazole, amphotericin B, and cefuroxime; and a partial conjunctival flap.  Pathology from the cornea showed GMS and PAS stains positive for fungal forms.  She did well post-operatively with improvement in her symptoms and exam.

Discussion:  C. dubliniensis is a yeast closely related to Candida albicans that was first described in 1995 as a cause of oral candidiasis in patients with AIDS.  There are a few published cases of endophthalmitis due to C. dubliniensis in the ophthalmology literature, but to our knowledge, no cases of fungal keratitis due to this organism have been reported.  Studies of C. dubliniensis susceptible have demonstrated emerging fluconazole resistance but nearly all reported isolates have shown susceptibility to amphotericin B and voriconazole

Conclusion:  C. dubliniensis is an uncommon cause of fungal keratitis that can be difficult to identify and treat but is generally susceptible to both amphotericin B and voriconazole.

2017 Agenda and Abstracts | < Previous Next >