Purpureocillium lilacinum Corneal Ulcer: A Rare Pathogen in an Immunocompetent Patient

Abstract

Abstract: We present a rare case of fungal corneal ulcer in a 51-year-old woman, contact lens wearer who demonstrated a poor response to topical and systemic antifungal treatment but showed improvement after intrastromal voriconazole injection. The patient underwent a corneal biopsy and pathology of the excised tissue identified acute necrotizing fungal keratitis from Purpureocillium lilacinum . To our knowledge, this is the first report of intrastromal voriconazole leading to successful treatment. This case highlights the need to consider uncommon pathogens in treatment-resistant corneal ulcers while waiting for culture results, making prompt management crucial to prevent severe complications.