PMC7647773_01
Slit-lamp image of the right eye at presentation. Dark multilobular lesions within deep stroma and a Descemet Stripping Automated Endothelial Keratoplasty graft as a subtle ring.
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fig1
Two months after DSAEK, he was referred to our hospital due to keratitis on the RE (Figure 1).
Anterior segment optical coherence tomography images of the patient at presentation. Graft-host interface and the stromal infiltrate with a shadow in the corneal stroma underlying the fungal lesion.
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Germany) was used to document the stromal infiltrate, showing the central infiltrate affecting all layers and the peripheral infiltrate concentrating in deep stroma (Figure 2). Given the spread and extent of the infection, an urgent surgical approach was chosen; therefore, no topical or systemic antifungal was performed before surgery.
Microbiological examination. (a) Direct microscopy of ocular exudate: pigmented septate hyphae with some yeast cells. (b) Primary culture in blood agar medium and incubated at 37 C: black yeast colonies. (c) Primary culture in Sabouraud agar medium and incubated at 25 C: pigmented filamentous colonies. (d) Microscopic examination of the colonies.
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fig3
Diagnosis was established by a positive direct examination and culture (Figure 3) of the same fungus from the surgically obtained corneal button.