Familial Cluster Of Fungal Keratitis: An Unusual Simultaneous Presentation In Three Members

To report a rare cluster of fungal keratitis caused by Aspergillus Niger in three members of the same family, presenting within a two-week period.

Tertiray eye Hopsital in Western India

. The index case, an 11-year-old boy, presented with acute onset pain, redness, photophobia, in the left eye. Clinical examination revealed a large, dry corneal ulcer with feathery margins, suggestive of fungal etiology. Subsequent inquiry revealed similar ocular symptoms in his 15-year-old sister and 38-year-old mother. Corneal examinations confirmed fungal keratitis in both, with corneal scrapings positive for fungal elements in two cases and cultures identifying Aspergillus Niger in all three. Treatment with hourly topical Natamycin 5% eye drops resulted in significant clinical improvement within one week and complete ulcer resolution with residual corneal opacities by four weeks. This familial cluster underscores the importance of early diagnosis, family screening, and prompt antifungal therapy in managing fungal keratitis. To our knowledge, simultaneous fungal keratitis in multiple family members is exceptionally rare and not widely reported in the literature.

In summary, the simultaneous occurrence of Aspergillus Niger keratitis in three members of a single family represents an unprecedented cluster with no prior significant documentation in the literature. While the exact mechanism remains unclear, shared environmental exposure remains the most plausible explanation. This report not only adds to the spectrum of fungal keratitis presentations but also calls for further research into environmental reservoirs, host susceptibility, and the epidemiology of such rare familial clusters.