Periconia species - An unusual fungal pathogen causing mycotic keratitis

Purpose: The purpose of this study is to determine the epidemiology, risk factors, clinical features, and treatment outcome of molecularly diagnosed Periconia keratitis. Methods: Clinical records of all culture proven fungal ulcers with molecular identification suggestive of Periconia species who presented to a single tertiary referral center from January 2012 to December 2013 were retrospectively analysed. Results: Among 1356 cases of keratomycosis, 8 (0.6%) patients were affected due to Periconia species. The mean age of presentation was 59 years with males (n = 6; 75%) were more commonly affected than females (n = 2; 25%). Significant history of trauma was present only in one patient. The infiltrate size was less than 5mm in majority of patients 75% (n = 6). 50% (n = 4) responded to antifungal, 12.5% (n = 1) responded to antibacterial, 12.5% (n = 1) required therapeutic penetrating keratoplasty, 25% (n = 2) lost to follow up after first visit. The mean duration of treatment in healed cases was 20 days. Conclusion: This is the first report on Periconia sp causing human corneal ulcer. This study signifies the importance of molecular identification in the diagnosis of rare fungi which will improve our understanding on disease pathology and outcome. Visual prognosis appears good if the infection is diagnosed and topical antifungal interventions started early.