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Fusarium Keratitis

Pictures of Fusarium keratitis and disease information have been excerpted from VisualDx clinical decision support system as a public health service. Additional information, including symptoms, diagnostic pearls, differential diagnosis, best tests, and management pearls, is available in VisualDx.

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Synopsis

In 2006, the CDC investigated a multistate outbreak of fungal keratitis due to Fusarium species that was associated with a specific type of contact lens solution, which was subsequently withdrawn from the market.

Fusarium keratitis is a serious corneal stromal infection with the filamentous non-pigmented Fusarium species. Infection with Fusarium solani, one of the more than 20 known species of Fusarium, is usually the most virulent Fusarium infection. If untreated, Fusarium keratitis can result in permanent corneal scarring and injury. The number of cases of fungal keratitis, including cases of Fusarium keratitis, have been rising during the past few decades. 

Most cases of Fusarium keratitis are seen in the southeast United States or in warmer climates. In the northeast, most cases of fungal keratitis are due to Aspergillus species. Prior use of immunosuppressive agents, trauma, and recent ophthalmologic surgery are known risk factors for fungal keratitis. Contact lens use was an infrequent risk factor before the 2006 outbreak.

Symptoms of Fusarium keratitis include eye pain, foreign body sensation, redness, tearing, discharge, and light sensitivity.

Look For

Fungal keratitis in general causes single or multiple corneal infiltrates with gray-white feathery edges, often with associated satellite lesions. There may be underlying corneal edema and/or an anterior chamber reaction. Advanced cases may demonstrate a hypopyon, a layering of white blood cells in the inferior anterior chamber angle.

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