Series of five cases of Papulaspora equi keratomycosis.

PURPOSE: The aim of this study was to describe a case series of Papulaspora equi keratomycosis, with clinical and laboratory characteristics of an organism that has not been reported from scrapings of corneal ulcers from humans.

METHODS

This is a retrospective chart review of 5 patients whose diagnostic corneal scrapings had grown P. equi on culture between 2008 and 2013. The clinical presentation, diagnostic tests, management, and the outcome of the ulcers are described.

RESULTS

All patients showed characteristic features of fungal corneal ulcers on clinical examination. Only 2 of the 5 patients reported having a history of injury to their eyes. One patient showed surface pigmentation that could mimic a dematiaceous ulcer. All the patients responded to topical antifungal treatment with 5% natamycin or prepared 2% ketoconazole drops.

CONCLUSIONS

Corneal ulcers may be caused by rare organisms, as in our series of patients who had P. equi keratomycosis, a hitherto unreported human pathogen. All the patients responded to treatment with conventional topical antifungal medications.