Case of Arthrographis kalrae Ethmoid Sinusitis and
Ophthalmitis in the People's Republic of China
1: J Clin Microbiol. 2004 Oct;42(10):4828-31.
First Case of Arthrographis kalrae Ethmoid Sinusitis and Ophthalmitis in
the People's Republic of China.
Xi L, Fukushima K, Lu C, Takizawa K, Liao R, Nishimura K.
Department of Dermatology, The Second Affiliated Hospital, Sun Yat-Sen
University, No. 107, West Yanjiang Rd., Guangzhou 510120, People's
Republic of China.
We present here the first case in the People's Republic of China of
human disease caused by the fungus Arthrographis kalrae. The male
patient had fungal panophthalmitis and invasive sinusitis involving the
maxillary and ethmoid sinuses. He was an apparently healthy man before
receiving trauma to his left eye. He complained of pain and loss of
visual acuity in the injured eye, which displayed redness and edema and
eventually discharged pus. His symptoms became more severe after he was
treated with steroids and several antibacterial agents. A computed
tomography scan of the left eye revealed that the maxillary and ethmoid
sinuses were involved. A smear of purulent material from the left eye
orbit revealed fungal elements, and cultures of the material grew a
fungus. The isolate was identified as A. kalrae based on gross and
microscopic morphologies, biochemical assays, and DNA sequence analysis.
The patient received amphotericin B intravenously, itraconazole orally,
and atomized allitridum by nebulizing allitridum therapy. The patient's
wound healed following surgical intervention, but the patient lost the
use of his left eye. This case should remind ophthalmologists and other
clinicians to consider the possibility of infections being fungal when
antibacterial agents have no effect and the patient's condition worsens.