Fungal Keratitis Secondary to Trametes betulina: A Case Report and Review of Literature

Joshua S. Hardin, Deanna A. Sutton, Nathan P. Wiederhold, James Mele, Sunali Goyal

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We report the first case of human infection and keratitis secondary to Trametes betulina, a rare filamentous fungus. Methods: Clinical examination including external and slit-lamp examination and corneal scrapings with microbiologic evaluation were performed on a patient with chronic allergic conjunctivitis, entropion and a long-standing corneal ulcer resistant to treatment. Results: The culture from the corneal scraping revealed a basidiomycetous fungus which was submitted for identification. DNA extraction with sequencing and analysis of the ITS and D1/D2 regions were performed on the isolate and demonstrated 100% similarity to Lenzites betulina/Trametes betulina. Susceptibility testing demonstrated potent in vitro activity of voriconazole (MIC < 0.03 μg/ml). The patient was treated with voriconazole, and the corneal ulcer and infiltrate resolved. The infection resulted in corneal thinning and a dense central corneal scar. Penetrating keratoplasty was performed 5 months after diagnosis and treatment and revealed stromal scarring without fungal elements. Conclusion: This is the first reported case of keratitis caused by Trametes betulina. This organism should be considered in the differential diagnosis for rare filamentous fungal keratitis and its treatment with voriconazole also noted.

Original languageEnglish (US)
Pages (from-to)755-759
Number of pages5
JournalMycopathologia
Volume182
Issue number7-8
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Keywords

  • Basidiomycete
  • Cornea
  • Fungus
  • Keratitis
  • Lenzites betulina
  • Trametes betulina

ASJC Scopus subject areas

  • Microbiology
  • Applied Microbiology and Biotechnology
  • Agronomy and Crop Science
  • veterinary (miscalleneous)

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