Initial Case Report of Cladorrhinum samala Mycotic Keratitis

Supplemental Digital Content is Available in the Text. Purpose: The purpose of this study was to report the first case of keratitis caused by Cladorrhinum samala and review of the literature. Methods: This was a case report and literature review. Results: A 35-year-old immunocompetent man presented with pain, redness, and watering in the right eye 7 days after trauma with some foreign body. He was diagnosed with infectious keratitis, and a thorough microbiological workup was performed. Corneal scrapings were subjected to a potassium hydroxide (KOH) examination, Gram staining, bacterial (blood agar and Robertson cooked meat broth), and fungal culture (Sabouraud dextrose agar and brain–heart infusion agar). The KOH mount revealed septate fungal hyphae with irregular margins. Yellow–white nonsporulating mycelial growth was noted on the Sabouraud dextrose agar, which was identified as C. samala by sequencing. The patient responded to 5% natamycin and 1% voriconazole eye drops, and there was a formation of a corneal opacity in a period of 3 weeks. Conclusions: We report the first case of keratitis by C. samala, highlighting the emergence of a rare dematiaceous fungi causing keratitis and the role of molecular modalities in the diagnosis of nonsporulating fungi in suspected cases.