PMC7519859_01
(A) Slit-lamp examination of the left eye demonstrates 2+ conjunctival injection with a central, feathery infiltrate and corneal edema. A 1 mm hypopyon is also present. (B) Fluorescein staining confirmed the presence of an overlying epithelial defect. (C) Lactophenol-cotton-blue stained microscopy reveals typical branched and densely clustered phialides. (D) Violaceous-red-rose pigmented and velvety colonies grew on Sabouraud agar.
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Slit-lamp examination of the left eye revealed a central corneal infiltrate with feathery borders measuring 2.4 mm x 2.0 mm with an overlying epithelial defect with associated satellite lesions, 2+ stromal edema, and presence of keratic precipitates with hypopyon inferiorly (Figure 1A and B). Three days later, the preliminary corneal cultures on blood and Saboraud's agars revealed fungal elements (Figure 1C). Final culture and speciation results indicated Purpureocillium lilacinum as the causative agent (Figure 1D).
(A) Thin slit beam view highlights the anterior stromal involvement and partial light-blocking nature of the scar. (B) Sclerotic scatter highlights residual stromal scar. (C) Anterior segment optical coherence tomography highlights the border and depth of anterior stromal scarring.
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After approximately 3 months of voriconazole monotherapy, the infiltrate regressed, leaving behind a partially light-blocking anterior stromal scar (Figure 2A-C).