PMC4164285_01
Diffuse lamp examination photograph taken at the first visit. Small whitish infiltrates are observed in the superficial corneal stroma at the 8 o'clock area.
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At his first visit to the Nagata Eye Clinic, in October 2012, slit-lamp examination demonstrated a small, whitish infiltrate, starting at the superficial stroma and continuing until one-third the stromal depth at the 8 o'clock area (Figure 1).
At 9 days after the patient's first visit, characteristic interface infiltration was observed (arrow) between the graft and host cornea, which is enlarged around the ulcer and within the DSAEK area.. Abbreviation: DSAEK, Descemet stripping automated endothelial keratoplasty.
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Slit-lamp examination showed that there was an enlarged deep corneal stromal infiltrate (Figure 2).
Smear of the corneal scraping that shows budding yeasts.
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A smear of corneal scraping revealed yeast that was later identified as C. albicans (Figure 3).
Blood coagulation was observed within the interface between the graft and host cornea (arrows) on the day after an intrastromal injection of the antimycotic agent.
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The day after the injection, a blood influx from the neovascularization was observed in the interface space between the host cornea and the graft (Figure 4).
Histological analysis of the excised cornea. Descemet's membrane was detached due to the pathological process (arrow). Inflammatory cells and fibrin are observed filling the perforated area (*) and spreading into the surrounding tissue (**). Grocott staining (inset) indicates the presence of a few fungal organisms.
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Histopathological examination of the excised corneal specimen revealed that there was an accumulation of numerous inflammatory cells and fibrous tissue at the interface between the graft and host cornea (Figure 5). Grocott staining demonstrated a few fungal organisms found in the tissue (Figure 5, inset).