Abstract
We report a case of infectious keratitis caused by the fungal pathogen Exserohilum rostratum in an immune-competent patient in South Africa. A 67-year-old man with hypertension presented with a painful red left eye two weeks after trauma with an organic foreign body. Slit-lamp biomicroscopy revealed a corneal ulcer with underlying stromal infiltrates, feathery margins and a hypopyon. Exserohilum rostratum was identified using fungal PCR testing on culture grown from a corneal scrape, and the patient responded to topical 5% natamycin eye drops. Corneal scarring limited final visual outcomes to Counting Fingers at 50cm. In conclusion, E. rostratum keratitis was previously rare, but is now considered an emerging corneal pathogen which can occur in temperate climates.
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