INFECTIOUS CRYSTALLINE KERATOPATHY CAUSED BY CANDIDA-GUILLIERMONDII

PURPOSE: To describe the manifestations of infectious crystalline kera topathy caused by Candida guilliermondii in a corneal transplant perfo rmed for pseudophakic bullous keratopathy. METHOD: Case report. RESULT S: Candida guilliermondii was identified as the causative organism of an indolent infectious crystalline keratopathy. Incisional lamellar bi opsy provided diagnostic culture and histopathologic results. Histopat hology showed aggregates of yeast elements between corneal stromal lam ellae, without inflammation. The infection progressed despite a 6-week course of topical amphotericin B and an additional 6-week course of t opical and oral fluconazole. Repeat penetrating keratoplasty resulted in clear graft, with no recurrent infection. CONCLUSIONS: Fungal kerat opathy should be in eluded in the differential diagnosis of infectious crystalline keratopathy, Numerous Candida species have been isolated in addition to the most common causative bacterial organism, Streptoco ccus viridans. Candida guilliermondii is yet one more causative agent of infectious crystalline keratopathy, Candida guilliermondii, a rare human pathogen, was resistant to medical therapy in this case. (C) 199 8 by Elsevier Science Inc. All rights reserved.