Fungal keratitis due to Scopulariopsis brevicaulis and a potential promising therapeutic effect of antibacterial agents: A case report

INTRODUCTION: Microbial keratitis is a serious potentially blinding corneal infection. Contact lens wear remains the most common predisposing factor. Fungal keratitis represent only a small fraction of the overall number of cases of contact lens-associated microbial keratitis, however they are proportionally more severe. PATIENT CONCERNS: An 18-year-old female, who occasionally used eye cosmetic soft contact lenses, presented with pain, redness, and blurring of vision in her left eye. DIAGNOSIS: The left eye showed decreased visual acuity, central corneal ulcer and abscess, and severe ciliary injection. A provisional diagnosis of infectious keratitis was considered. INTERVENTION: Corneal scrapings were aseptically collected and directly inoculated onto sterile bacterial and fungal agar plates that were immediately incubated. The patient was admitted and started on topical and systemic antibacterial agents. OUTCOMES: The infection showed signs of satisfactory clinical resolution. However, the mold Scopulariopsis brevicaulis was isolated in pure colonies 5 days after presentation. CONCLUSION: We report the first case from Jordan of fungal keratitis caused by the mold S brevicaulis. A high index of suspicion is required for fungal keratitis caused by S brevicaulis in immunocompetent patients who wear contact lenses despite its rarity. This fungal infection was successfully treated using antibacterial agents. However, larger studies are recommended to investigate the clinical effectiveness of antimicrobial agents that have both antibacterial and antifungal effects and to assess their role as empirical therapeutic modalities for infectious keratitis.