Phaeoacremonium iranianum - a new corneal pathogen.

Background: Phaeoacremonium is typically found in the environment and can cause diseases in woody plants. It is rarely responsible for infections in humans.

Case presentation: In this report, we present a case of corneal infection caused by Phaeoacremonium iranianum. Caused a fan-shaped grayish-white ulcer measuring approximately 4 mm×3 mm inferior nasal cornea. The ulcer appeared relatively dry, with noticeable swelling and cloudiness in the surrounding cornea. The visual acuity after infection was 0.25. We started an aggressive antifungal therapy. Our antifungal susceptibility testing revealed the Minimum Inhibitory Concentration of anifengin was 4 µg/ml, Micafengin and carpofungin exceeding 8 µg/ml, fluorocytosine was 32 µg/ml, posaconazole was 1 µg/ml, voriconazole was 0.5 µg/ml, itraconazole was 2 µg/ml, fluconazole was 64 µg/ml, and amphotericin was 0.05 µg/ml. The patient underwent keratectomy combined with antifungal therapy. A month later, the conjunctiva of the right eye was congested, and a 4*4 mm corneal opacity was visible inferior nasal cornea, with local obvious thinning and a little keratic precipitates on the inner skin, and the infection has been controlled.

Conclusions: We detail the progression and treatment of this infection to contribute to the clinical understanding and management of such cases.