Aspergillus fumigatus keratitis with wreath pattern infiltrates

Cornea. 2001 Jul;20(5):534-5. doi: 10.1097/00003226-200107000-00019.


Purpose: To report a case of Aspergillus fumigatus keratitis with clinical features simulating Nocardia keratitis and to highlight the utility of microbiologic investigation in the successful management of infectious keratitis.

Method: Case report.

Results: A 62-year-old man presented with complaints of pain, redness, and watering of 10 days' duration in his right eye. Direct microscopic observation of smears of corneal scrapings revealed a fungal etiology. The patient was treated with 5% natamycin eye drops and 1% atropine sulphate eye drops and was advised to visit the hospital for observation. During his visit to the hospital on day 10 after medication, the eye demonstrated a wreath pattern corneal infiltrate that simulated Nocardia keratitis. The fungus grown from culture of corneal scraping was identified as A. fumigatus.

Conclusion: This report highlights the significance of subjecting corneal scrapings from suspected cases of infectious keratitis to microbiologic evaluation and emphasizes the fact that a complete microbiologic work-up helps in establishing a definitive etiologic diagnosis and initiating specific antimicrobial therapy.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy
  • Aspergillosis / microbiology
  • Aspergillus fumigatus / isolation & purification*
  • Atropine / therapeutic use
  • Cornea / microbiology
  • Drug Therapy, Combination
  • Eye Infections, Fungal / diagnosis*
  • Eye Infections, Fungal / drug therapy
  • Eye Infections, Fungal / microbiology
  • Humans
  • Keratitis / diagnosis*
  • Keratitis / drug therapy
  • Keratitis / microbiology
  • Male
  • Middle Aged
  • Mydriatics / therapeutic use
  • Natamycin / therapeutic use


  • Antifungal Agents
  • Mydriatics
  • Atropine
  • Natamycin