A case of fungal keratitis caused by Aspergillus flavus and the laboratory study of the pathogen
Objective Here we reported a clinical case of fungal keratitis caused by Aspergillus flavus,and the relevant la-boratory testing process about this pathogen.Methods A sample of infected corneal scrape from a hospitalized keratitis pa-tient was cultured in our laboratory.The species identification and the in-vitro antimicrobial susceptibility of the isolated pathogen were performed.The general clinical data concerning keratitis caused by this pathogen in previous published resear-ches were reviewed.Results Filamentous fungus colonies were obtained from the culture of the patient's corneal scraping sample.The morphological method and MALDI-TOF MS both identified the mold colonies as A.flavi complex.The con-crete species level information of this mold was reveled by calmodulin gene sequencing method was A.flavus.The in-vitro antifungal susceptibility profiles of this isolate to seven antifungal drugs commonly used in clinic were totally susceptible through the Sensititre YeastOne colorimetric plate method.The clinical outcome of this patient was poor with enucleation of the infected eyeball even the antifugal therapeutic regimen adjusted timely.The previously published studies generally sug-gest that the clinical symptoms of Aspergillus keratitis were severe,and voriconazole with long course was recommended as the first-line treatment.Conclusions The diagnosis and treatment of keratitis caused by Aspergillus is comparatively diffi-cult;accurate species and in-vitro susceptibility information of the pathogen provided by clinical laboratory is helpful for di-agnosis and treatment of fungal keratitis.Molecular diagnostic techniques independent of culture methods are promising in assisting the early clinical diagnosis of Aspergillus keratitis.