Fine needle aspiration cytology diagnosis of a fungal lesion of the Verticillium species. A case report

Verticillium Species Skin Infection in a Renal Transplant Patient

Verticillium species is a filamentous fungus that inhabits decaying vegetation and soil. It is known to cause disease in plants. Four cases of human infections have been reported previously in nontransplant patients. Here, we report the first case of Verticillium species skin infection in a transplant patient who was successfully treated with fluconazole monotherapy.

Keratitis caused by Verticillium species

PURPOSE

To report a case of fungal keratitis caused by Verticillium species.

METHODS

A 50-year-old man developed pain, redness, and an infiltrate in his left eye and had no history of trauma. The cornea showed superficial, white, stromal infiltrates and epithelial ulceration with a dendritic margin. The clinical features suggested herpetic keratitis, and the patient was treated with topical antiviral medication. Two weeks later, his condition deteriorated. Examination of the left eye showed stromal infiltrates with a feathery margin and epithelial ulceration with its covering white exudates. Corneal scrapings were taken for direct microscopic examination and culture.

RESULTS

Corneal scraping showed the presence of fungal filaments. The fungus was identified as Verticillium species. Topical amphotericin B and systemic fluconazole were started after discontinuing the antiviral treatment. Clinically, the inflammation subsided during the 3 weeks after treatment.

CONCLUSION

This is a rare case of infectious keratitis caused by Verticillium species. Rare species of fungal infection should be considered in the differential diagnosis of stromal keratitis refractive to conventional medical treatment.