case_images: PMC11729674_01
case_images: (A) Slit lamp examination, shows 7 x 7 mm gray-white feathery margin stromal infiltrate at center of cornea. (B) On the 12th day of the treatment, deep stromal infiltration, diffuse corneal edema, and hypopyon were progressed. (C) Four months after T-PKP. (D) Fusarium spp. grew on Sabouraud dextrose agar.
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case_images: The culture showed Fusarium sp. (day 5), but bacterial cultures and a PCR test for HSV were negative (Fig. 1). Stromal corneal edema and necrosis increased and affected the rest of the cornea (Fig. 1).
case_images: Microscopic examination of H/E-stained slide shows corneal ulceration and neutrophilic infiltration (Arrow) magnification X100. Microscopic features of Hematoxylin and eosin (H/E) stained slides on corneal biopsy include ulceration, neutrophilic infiltrates and presence of characteristic double-walled cystic structure in the corneal stroma with various states of degeneration and also the presence of spectated fungal hyphae, both organisms were positive in Periodic Acid-Schiff (PAS) special staining.
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case_images: fig2
case_images: The histopathology results showed positive for Acanthamoeba cysts and fungal elements. (Fig. 2, Fig. 3), and PCR confirmed Acanthamoeba.