A case of rare fungal keratitis caused by Pseudoshiraia conidialis

Rationale: Pseudoshiraia conidialis is a filamentous fungus that belongs to the Shiraiaceae family. We report a rare case of fungal keratitis caused by P conidialis . Patient concerns: A 61-year-old female accidentally scratched her right eye with a bamboo branch, presenting with conjunctival congestion in the right eye, corneal ulcer with edema endothelial folds, anterior chamber exudation hypopyon, and lens opacity. Diagnoses: The patient’s eyes were evaluated using slit-lamp examination, fundus examination, and pus culture, and fungal keratitis was considered as the diagnosis. After culturing, the keratitis pathogen was confirmed to be P conidialis through rRNA gene internal transcribed spacer amplification and sequencing. Interventions: The patient underwent debridement of the cornea and was treated with a combination of tropicamide eye drops and oral itraconazole hydrochloride capsules. Outcomes: The patient showed significant improvement early in the treatment, but was not cured. Later, the patient was transferred to another hospital and was lost to follow-up. Lessons: We report the first case of fungal keratitis caused by P conidialis . Microbial culture remains the gold standard for diagnosing fungal keratitis. This case provides a reference for the clinical treatment of fungal keratitis caused by P conidialis.