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LETTER TO EDITOR  
Year : 2011  |  Volume : 54  |  Issue : 2  |  Page : 408-410
Corneal abscess caused by Bipolaris spicifera


1 Department of Microbiology, Bharati Vidyapeeth Medical College and Hospital, Sangli, Maharashtra, India
2 Department of Ophthalmology, Bharati Vidyapeeth Medical College and Hospital, Sangli, Maharashtra, India

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Date of Web Publication27-May-2011
 

How to cite this article:
Patil S, Kulkarni S, Gadgil S, Joshi A. Corneal abscess caused by Bipolaris spicifera. Indian J Pathol Microbiol 2011;54:408-10

How to cite this URL:
Patil S, Kulkarni S, Gadgil S, Joshi A. Corneal abscess caused by Bipolaris spicifera. Indian J Pathol Microbiol [serial online] 2011 [cited 2019 Dec 15];54:408-10. Available from: http://www.ijpmonline.org/text.asp?2011/54/2/408/81594


Sir,

Bipolaris is one of the several graminicolous fungi (living on plant, particularly grasses) and is a frequent cause of phaeohyphomycosis. It is often implicated as a cause of fungal sinusitis, peritonitis, meningitis, and disseminated disease in neonate.

A 38-year-old male presented in the ophthalmology department with pain, redness, and watery discharge from the right eye for the past 8 days. There was history of vegetative trauma to the right eye while cutting sugarcane, 4 days prior to the onset of symptoms. On examination, there was mild lid edema, congested conjunctiva, and partially impaired vision. Slit lamp examination showed corneal abscess measuring 3 mm × 2 mm in pupilary area, with streak of hypopyon and presence of satellite lesions.

Corneal scrapings were collected under aseptic condition and were subjected for microscopy and culture. Potassium hydroxide (KOH) preparation and gram staining revealed thick, brown, branching, septate hyphae. Pure growth of white mycelial colony was obtained on Sabouraud dextrose agar (SDA), after 3 days of incubation at room temperature. Colony turned to gray black with black pigmentation on reverse after further incubation. Lactophenol cotton blue preparation of the growth from SDA showed brown septate hyphae with sympodial geniculate conidiophores, bearing multicellular conidia with thick transverse septa. The isolate was identified as Bipolaris species by demonstration of formation of germ tube from both poles of macroconidia, extending parallel to its long axis after incubation of spores in distilled water for 2-4 h at room temperature [Figure 1]. The species was identified as Bipolaris spicifera on the basis of morphology of conidia, which showed predominantly three transverse distosepta and four cells. A flattened hilum was seen on the basal cells [Figure 2]. Patient was treated with natamycin and atropine eye drops for next 7 days. First follow-up after 3 days of treatment showed decreased conjunctival and ciliary congestion and disappearance of hypopyon. When patient visited 1 week after the completion of treatment, there was complete resolution of the lesion with restoration of the vision to normal.
Figure 1: Formation of germ tube from both poles of macroconidia, extending parallel to its long axis (×400)

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Figure 2: Lactophenol cotton blue preparation of the slide culture of the fungal isolate showing brown septate hyphae with sympodial geniculate conidiophores, bearing multicellular conidia (×100)

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The genus Bipolaris currently accommodates three species, such as B. australiensis, B. hawaiiensis, and B. spicifera. Its colony morphology on SDA resembles to Drechslera. The germ tube test is of great importance to differentiate Bipolaris and Drechslera.

Mycotic keratitis frequently develops after corneal trauma by vegetative matter. Its management poses a challenge to ophthalmologist. Fungal isolation and identification has contributed to an early establishment of diagnosis of this clinical entity. Dematiaceous fungi accounts for 7-16% of the cases of keratomycosis. [1] There are scanty reports on Bipolaris spicifera as a cause of keratomycosis in the literature. Hemashettar et al. [2] and Koshy et al.[3] have reported one case each in 1992 and 2002, respectively, in leprosy patients. While Saha et al. have come across only one case of keratomycosis in 5 years of their study. [1] Bipolaris species occasionally have been reported to cause ocular infection like endophthalmitis [4] and asymptomatic fungal cyst of conjunctiva. [5] As B. spicifera is an uncommon cause of corneal abscess, precise identification of this causative fungus and institution of appropriate treatment strategy could save the eye from this preventable cause of blindness.

 
   References Top

1.Saha R, Das S. Mycological profile of infectious keratitis from Delhi. Indian J Med Res 2006;123:159-4.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Hemashettar BM, Veerappa TS, Verma PV, Hanchinamani S, Patil CS, Thammayya A. Mycotic keratitis caused by Bipolaris spicifera. Indian J Pathol Microbiol 1992;35:274-7.  Back to cited text no. 2
[PUBMED]    
3.Koshy S, Ebenezer D. Bipolaris Keratomycosis in Leprosy patient: A case report. Lepr Rev 2002;73:76-8.  Back to cited text no. 3
    
4.Bashir G, Hussain W, Rizwi A. Bipolaris hawaiiensis keratomycosis and endophthalmitis. Mycopathologia 2009;167:51-3.  Back to cited text no. 4
    
5.Eghtedari M, Pakshri K. Asymptomatic fungal cyst of conjunctiva caused by Bipolaris spicifera. Iran J Med Sci 2006;13:56-8.  Back to cited text no. 5
    

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Correspondence Address:
Sunanda Kulkarni
Department of Microbiology, Bharati Vidyapeeth Medical College and Hospital, Sangli, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.81594

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    Figures

  [Figure 1], [Figure 2]

This article has been cited by
1 Unilateral renal phaeohyphomycosis due toBipolaris spiciferain an immunocompetent child - rare case presentation and review of literature
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Mycoses. 2015; 58(7): 437
[Pubmed] | [DOI]



 

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