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Colletotrichum graminicola keratitis: first case report from India.

Yegneswaran PP, Pai V, Bairy I, Bhandary S - Indian J Ophthalmol (2010 Sep-Oct)

Bottom Line: Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes.In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses.The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, India.

ABSTRACT
Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants). In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum graminicola is rare. We diagnosed Colletotrichum graminicola keratitis in a 44-year-old man who presented with a non-healing corneal ulcer since three weeks. Positive smears and cultures from the corneal scrapings established the causative organism as C. graminicola. The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin. Infection resolved over 10 weeks and antimicrobials were stopped. We describe the clinical presentation and treatment outcome of Colletotrichum graminicola keratitis.

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Macroscopic morphology showing salmon-colored colony with felt-like aerial mycelium. Note the numerous black sclerotia
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Figure 0003: Macroscopic morphology showing salmon-colored colony with felt-like aerial mycelium. Note the numerous black sclerotia

Mentions: Corneal scrapes were obtained from the active edges and smears were sent for staining with Gram, Giemsa and potassium hydroxide (KOH). Material was inoculated onto plates for bacterial, fungal and Acanthamoeba culture. Sabouraud’s dextrose agar (SDA) and sheep blood agar (SBA) were incubated at 28°C and 37°C, respectively. For culturing Acanthamoeba, non-nutrient agar with Escherichia coli overlay was employed and incubated at ambient temperature. Smears revealed fungal filaments [Fig. 2]. After two days, filamentous fungi was grown on SDA; gradually, at the end of two weeks, the colony assumed a salmon color with numerous black sclerotia [Fig. 3] and an orange color on the reverse that later became dark brown. A lactophenol cotton blue tease mount preparation from the colonies showed abundant setae [Fig. 4] wide, falcate, fusiform conidia gradually tapering at the apex and base and abundant appressoria with irregular margins. The fungus was initially identified as Colletotrichum graminicola and further confirmation carried out at the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Utrecht, Netherlands. Antifungal susceptibility testing for the isolate was performed using the Clinical and Laboratory Standards Institute Document M38-A2. The minimum inhibitory concentration (expressed as microgram per milliliter) for amphotericin, itraconazole and ketaconazole at 48 h and 72 h was found to be 0.5/1, 0.5/1 and 1/2 respectively. SBA was sterile after 48 h of aerobic incubation and there was no culture recovery of Acanthamoeba.


Colletotrichum graminicola keratitis: first case report from India.

Yegneswaran PP, Pai V, Bairy I, Bhandary S - Indian J Ophthalmol (2010 Sep-Oct)

Macroscopic morphology showing salmon-colored colony with felt-like aerial mycelium. Note the numerous black sclerotia
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992917&req=5

Figure 0003: Macroscopic morphology showing salmon-colored colony with felt-like aerial mycelium. Note the numerous black sclerotia
Mentions: Corneal scrapes were obtained from the active edges and smears were sent for staining with Gram, Giemsa and potassium hydroxide (KOH). Material was inoculated onto plates for bacterial, fungal and Acanthamoeba culture. Sabouraud’s dextrose agar (SDA) and sheep blood agar (SBA) were incubated at 28°C and 37°C, respectively. For culturing Acanthamoeba, non-nutrient agar with Escherichia coli overlay was employed and incubated at ambient temperature. Smears revealed fungal filaments [Fig. 2]. After two days, filamentous fungi was grown on SDA; gradually, at the end of two weeks, the colony assumed a salmon color with numerous black sclerotia [Fig. 3] and an orange color on the reverse that later became dark brown. A lactophenol cotton blue tease mount preparation from the colonies showed abundant setae [Fig. 4] wide, falcate, fusiform conidia gradually tapering at the apex and base and abundant appressoria with irregular margins. The fungus was initially identified as Colletotrichum graminicola and further confirmation carried out at the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Utrecht, Netherlands. Antifungal susceptibility testing for the isolate was performed using the Clinical and Laboratory Standards Institute Document M38-A2. The minimum inhibitory concentration (expressed as microgram per milliliter) for amphotericin, itraconazole and ketaconazole at 48 h and 72 h was found to be 0.5/1, 0.5/1 and 1/2 respectively. SBA was sterile after 48 h of aerobic incubation and there was no culture recovery of Acanthamoeba.

Bottom Line: Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes.In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses.The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, India.

ABSTRACT
Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants). In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum graminicola is rare. We diagnosed Colletotrichum graminicola keratitis in a 44-year-old man who presented with a non-healing corneal ulcer since three weeks. Positive smears and cultures from the corneal scrapings established the causative organism as C. graminicola. The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin. Infection resolved over 10 weeks and antimicrobials were stopped. We describe the clinical presentation and treatment outcome of Colletotrichum graminicola keratitis.

Show MeSH
Related in: MedlinePlus