Aureobasidium Pullulans Keratitis Following Automated Lamellar Therapeutic Keratoplasty.

Abstract

Aureobasidium pullulans is a rare cause of fungal keratitis. A 73-year-old man underwent Automated Lamellar Therapeutic Keratoplasty (ALTK) for healed trachomatous keratopathy in his left eye. Five days later, he developed a graft infection. Cultures from corneal scraping showed findings consistent with Aureobasidium pullulans. The keratitis failed to respond to intensive topical and systemic anti-fungal therapy. Hence, the lamellar graft was removed. Despite this, the clinical condition deteriorated and a therapeutic penetrating keratoplasty had to be carried out to salvage the eye. At 1 year follow-up, there was no recurrence of infection. Graft infection with Aureobasidium pullulans may not be amenable to topical and systemic antifungal therapy and a penetrating keratoplasty may be required for control of infection.