case_images: PMC10978041_01
case_images: Central corneal infiltrate on initial presentation.
case_images: cop-2024-0015-0001-538062_F01.jpg
case_images: PMC10978041_01_cop-2024-0015-0001-538062_F01.jpg
case_images: F1
case_images: Clinical assessment revealed an unaided visual acuity of 6/24 in the affected eye, accompanied by a central corneal infiltrate measuring less than 1 mm in diameter and an overlying pinpoint epithelial defect (Fig. 1).
case_images: Microscopy showing erect conidiophores with densely clustered, tapered phialides that gave rise to chains of ellipsoid conidia were highly suggestive of Purpureocillium lilacinum.
case_images: cop-2024-0015-0001-538062_F02.jpg
case_images: PMC10978041_01_cop-2024-0015-0001-538062_F02.jpg
case_images: F2
case_images: The subsequent scrape returned a positive result, confirming the presence of Purpureocillium lilacinum as the causative organism (Fig. 2).
case_images: Anterior segment optical coherence tomography demonstrating endothelial plaque formation on the corneal endothelium.
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case_images: F3
case_images: An early manifestation of endothelial plaque formation on the corneal endothelium was observed at the 1-week mark, a finding corroborated by anterior segment optical coherence tomography (Fig. 3).
case_images: LASIK flap secured in place using cyanoacrylate glue and interrupted sutures.
case_images: cop-2024-0015-0001-538062_F04.jpg
case_images: PMC10978041_01_cop-2024-0015-0001-538062_F04.jpg
case_images: F4
case_images: To create a patch graft, a 4-mm skin biopsy punch was employed, targeting the clear area of the flap. This graft was then affixed onto the perforated residual stromal bed using fibrin glue and further reinforced with 7, 10-0 nylon sutures (Fig. 4), effectively covering the perforation.
case_images: Anterior segment photograph after penetrating keratoplasty demonstrating clear cornea with no recurrence of infiltrate.
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case_images: F5
case_images: There were no instances of infection recurrence (Fig. 5).