Scytalidium Keratitis: Case Report in a Human Eye

Purpose: To describe the presentation and treatment of a case of an atypical reticular corneal infiltrate with surrounding immune-like ring in a young woman caused by Scytalidium fungal species. Methods: Interventional case report describing the clinical appearance, course, and treatment of Scytalidium keratitis. Results: A 21-year-old female equestrian with a history of soft contact lens wear was noted to have persistent keratitis and photophobia of the right eye after an injury with a volleyball. Although initially culture negative and responsive to topical steroids, the keratitis persisted, and repeat corneal scrapings and cultures revealed Scytalidium species. Treatment with topical amphotericin B 0.15% and oral fluconazole 200 mg twice daily eradicated the infection, and the patient had a final best-corrected visual acuity of 20/20. Conclusion: Scytalidium species fungal organisms can cause an indolent keratitis. Intensive oral and topical antifungal therapy was successful in eradicating the infection.