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Mycopathologia

, Volume 182, Issue 7–8, pp 755–759 | Cite as

Fungal Keratitis Secondary to Trametes betulina: A Case Report and Review of Literature

  • Joshua S. HardinEmail author
  • Deanna A. Sutton
  • Nathan P. Wiederhold
  • James Mele
  • Sunali Goyal
Article

Abstract

Purpose

We report the first case of human infection and keratitis secondary to Trametes betulina, a rare filamentous fungus.

Methods

Clinical examination including external and slit-lamp examination and corneal scrapings with microbiologic evaluation were performed on a patient with chronic allergic conjunctivitis, entropion and a long-standing corneal ulcer resistant to treatment.

Results

The culture from the corneal scraping revealed a basidiomycetous fungus which was submitted for identification. DNA extraction with sequencing and analysis of the ITS and D1/D2 regions were performed on the isolate and demonstrated 100% similarity to Lenzites betulina/Trametes betulina. Susceptibility testing demonstrated potent in vitro activity of voriconazole (MIC < 0.03 μg/ml). The patient was treated with voriconazole, and the corneal ulcer and infiltrate resolved. The infection resulted in corneal thinning and a dense central corneal scar. Penetrating keratoplasty was performed 5 months after diagnosis and treatment and revealed stromal scarring without fungal elements.

Conclusion

This is the first reported case of keratitis caused by Trametes betulina. This organism should be considered in the differential diagnosis for rare filamentous fungal keratitis and its treatment with voriconazole also noted.

Keywords

Cornea Keratitis Fungus Trametes betulina Lenzites betulina Basidiomycete 

Notes

Acknowledgements

The authors acknowledge Carmita Sanders for help with the phenotypic identification, and Dr. Hongxin Fan, and Kumari Vadlamudi for the molecular characterization.

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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  • Joshua S. Hardin
    • 1
    Email author
  • Deanna A. Sutton
    • 2
  • Nathan P. Wiederhold
    • 2
  • James Mele
    • 2
  • Sunali Goyal
    • 1
  1. 1.Jones Eye InstituteUniversity of Arkansas for Medical Sciences (UAMS)Little RockUSA
  2. 2.Department of PathologyUniversity of Texas Health Science Center at San Antonio (UTHSCSA)San AntonioUSA

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