Fungal Keratitis Caused by Alternaria alternata: A Rare Pathogen and Its Surgical Treatment.

Fungal keratitis is a serious eye disease that can lead to blindness. So far, 56 genera and 105 species of fungi have been identified as causes. This report details a case caused by a rare fungus, Alternaria alternata. The patient had lamellar keratoplasty after receiving local and systemic antifungal treatments, which successfully controlled the inflammation. The corneal grafts remained clear, and the transplant was successful. To identify the pathogen, we used colony morphology, electron microscopy, and molecular analysis, which revealed septate ellipsoid spores characteristic of A alternata. Despite being uncommon, these fungi are increasingly seen in clinical cases, highlighting the need for early diagnosis and combined surgical and antifungal treatment. Our study showed that lamellar corneal transplant is effective for difficult cases, especially when the infection endangers vision. Quick treatment with antifungal drugs, removal of infected tissue, and lamellar keratoplasty can improve outcomes in atypical fungal keratitis.