A rare case of Histoplasma Keratitis in an immunocompetent patient

Abstract

Purpose

To report an unusual case of isolated Histoplasma Keratitis in a healthy immune competent patient in a tertiary eye care centre in Western India.

Methods

A 50 year old patient diagnosed with microbial keratitis was investigated microbiologically and was proven to have Histoplasma Keratitis on the culture of the corneal scrapping. The patient was successfully treated with topical antifungals leading to resolution of keratitis.

Results

A 50 year old immune-competent patient with a central corneal infiltrate underwent corneal scrapping and the sample was sent for microbiology and culture. The culture growth showed growth of Histoplasma Capsulatum and was treated with topical Amphotericin B (0.15%) and natamycin (5%). The lesion resolved in 20 days to leave behind a faint nebular scar. No other ocular or systemic associations of Histoplasmosis were found on further investigation.

Conclusion

This is the second case report on Histoplasma Keratitis and the first one reported in an immune-competent patient in Indian subcontinent, to the best of our knowledge. Mycotic corneal infections being very common in India (temperate climate), it is imperative to do a detailed microbiological work-up of a patient with microbial keratitis. Isolated Histoplasma Keratitis can occur in immune-competent individuals. These patients respond very well to topical Amphotericin B (0.15%) and recover completely.