Lasiodiplodia Keratitis: A Case Series Of 27 Patients

To review 27 cases of microbial keratitis caused by Lasiodiplodia theobromae presenting to a tertiary eye care center in eastern India over seven‑year period and analyze the risk factors, clinical profile, microbiological characteristics, treatment, and outcome of patients.

We conducted a retrospective review of the medical records of patients with microbiologically proven Lasiodiplodia keratitis, between November 2015 and October 2022. The project was initiated after approval by the Institutional Ethics Committee (2022‑151‑BHR‑49) of L V Prasad Eye Institute, Bhubaneswar, India.

This is a retrospective review of 27 cases of microbial keratitis diagnosed with Lasiodiplodia theobromae between November 2015 and October 2022. Data were retrieved using the electronic medical record system. Additional outcomes such as average time of resolution, frequency, type, and outcome of surgical interventions, wherever performed, were also analyzed. Descriptive statistics were used to interpret the demographic data

The mean age of patients was 56.8 ± 18.7 years (range: 23–86), the male: female ratio was 2.4:1, and the average follow‑up was 90.2 days. Eleven (40.7%) patients had a history of trauma, and 16 (59.3%) presented with a large infiltrate (>6 mm). Samples from all the patients were culture‑positive for Lasiodiplodia theobromae, of which 26 (96.3%) were corneal scrapings and one (4%) was a half‑corneal button. Eight (29.6%) patients had coexisting bacterial infections. Successful management was achieved in 12 eyes (66.7%) with medical treatment alone (topical natamycin, n = 7; topical natamycin + oral ketoconazole, n = 3; and topical natamycin + topical gatifloxacin, n = 2). However, surgical intervention was required for nine (33.3%) eyes.

Lasiodiplodia theobromae is an uncommon cause of FK in humans, with no definite treatment reported in the literature. However, medical management can be initiated with topical natamycin (5%) eyedrops. Severity at presentation and response to the treatment can guide toward the need for any further surgical interventions or change in topical regimen. Multiple intravitreal amphotericin B injections can be considered in cases of intraocular spread into the vitreous cavity. Medical management with natamycin was effective in treating patients with Lasiodiplodia keratitis. However, advanced cases necessitated surgical intervention for complete resolution.