Fungal keratitis caused by Trichomonascus ciferrii in an immunocompetent adult

Fungal keratitis is a serious ocular infection that can result in permanent vision loss if not promptly diagnosed and treated. A healthy woman in her early 20s developed keratitis nearly 2 weeks after an ocular trauma with an organic material, a cardboard paper, on her left eye. Ocular examination revealed a mid-stromal corneal infiltrate with brush-like borders and hypopyon. The Giemsa stain of the corneal scraping demonstrated branching septated hyphae, and fungal culture grew Trichomonascus ciferrii resistant to amphotericin B. She was successfully treated with topical natamycin 5% drops for 2 weeks, leading to complete eradication of the corneal infection with a residual stromal scar. This case documented T. ciferrii, a rare fungal aetiology in post-traumatic keratitis in a tropical country, successfully treated with natamycin 5%. Despite the virulence of T. ciferrii , the infection was promptly treated, resulting in a good functional vision.