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Mycopathologia

, Volume 183, Issue 3, pp 565–571 | Cite as

Antifungal Susceptibility, Morphological and Molecular Characterization of Lasiodiplodia theobromae Isolated from a Patient with Keratitis

  • Priscila Dallé da Rosa
  • Claudete Locatelli
  • Karla Scheid
  • Diane Marinho
  • Lúcia Kliemann
  • Alexandre Fuentefria
  • Luciano Zubaran Goldani
Short Communication
  • 95 Downloads

Abstract

Lasiodiplodia theobromae is a rare ocular pathogen. We report a patient with fungal keratitis caused by L. theobromae. The patient was a 75-year-old male, a farmer with diabetes type II, and no previous history of ocular trauma. Histopathology analysis revealed the presence fungi invading Descemet’s membrane of the cornea. The fungus was characterized by septate, highly bulged fungal filaments involving full corneal thickness in the corresponding histopathology specimens. A dematiaceous mold was isolated and initally identified as L. theobromae by microscopic and macroscopic morphology, and further confirmed by PCR-based determination of internal transcribed spacer (ITS) regions of ribosomal DNA. Antifungal susceptibility tests showed sensitivity to amphotericin B (AMB) and voriconazole ( VRC), and resistance to other azoles, including itraconazole (ITC) and fluconazole (FLC). Corneal transplant was performed. Despite in vitro itraconazole resistance, the patient was successfully treated with oral itraconazole, topical voriconazole and natamycin, combined with ocular injections of amphotericin B and voriconazole.

Keywords

Fungal keratitis Corneal ulcer Lasiodiplodia theobromae Antifungal treatment Voriconazole Amphotericin B 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Priscila Dallé da Rosa
    • 1
  • Claudete Locatelli
    • 2
  • Karla Scheid
    • 2
  • Diane Marinho
    • 2
  • Lúcia Kliemann
    • 3
  • Alexandre Fuentefria
    • 4
  • Luciano Zubaran Goldani
    • 1
    • 5
  1. 1.Programa de Pós-Graduação em Medicina: Ciências MédicasUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  2. 2.Serviço de Oftalmologia, Hospital de Clínicas de Porto AlegrePorto AlegreBrazil
  3. 3.Departamento de Patologia da Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  4. 4.Programa de Pós-Graduação em Ciências FarmacêuticasUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  5. 5.Infectious Diseases Unit, Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil

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