A Case of Donor-Transmitted Candida Keratitis Despite Antifungal Fortified Storage Media

Purpose: To present a case of fungal keratitis and subsequent endophthalmitis after penetrating keratoplasty despite storage of donor tissue in media fortified with amphotericin B. Methods: Case report of donor-transmitted fungal keratitis progressing to fungal endophthalmitis despite storage of donor tissue in media fortified with amphotericin B. Results: A 51-year-old woman with recurrent granular corneal dystrophy underwent penetrating keratoplasty in her right eye with donor rim cultures later growing Candida albicans . Within 2 weeks, the eye developed findings concerning for fungal infection that persisted despite empiric antifungal therapy. Repeat penetrating keratoplasty was performed with a culture-negative graft, but fungal keratitis recurred and progressed to fungal endophthalmitis. The patient later developed persistent vision loss from infection-related complications. Conclusions: We present a case of donor-transmitted fungal keratitis progressing to fungal endophthalmitis despite storage of donor tissue in amphotericin B.