First report of rare fungal keratitis: Diaporthe aspalathi

Background The plant fungal pathogen Diaporthe aspalathi is the causal agent of the southern stem canker disease in soybean. However, human infection caused by D. aspalathi has not been previously reported. Case presentation We report a case of human keratitis caused by D. aspalathi on a 50-year-old woman. She presented to the hospital with redness, pain, decreased vision, and a focal white opacity in the left eye, which had been injured by a thorn 3.5 months earlier. Slit lamp examination revealed moderate conjunctival hyperemia, intact corneal epithelium, mild stromal edema, and thick white endothelial exudates in the inferior cornea. D. aspalathi was identified through DNA sequencing. The patient was treated with a combination of antifungal agents and therapeutic penetrating keratoplasty, resulting in scarring and vascularization of the graft. Conclusion Our report shows a rare case of corneal infection caused by D. aspalathi and highlights the importance of early suspicion of fungal keratitis in patients with a history of corneal plant trauma.