Dr.A. BALRAJ, B19536
12 year old boy with history of thorn injury presented with corneal infiltrates along limbus with thinning and concomitant scleritis. Scrapings and culture were negative. Patient was started on topical antibiotics and antifungals. As corneal thinning worsened in 10 days, peripheral ulcerative keratitis was suspected and low dose topical steroids was started. Infiltrates resolved well with complete resolution of scleral inflammation and stabilization of thinning. One month later patient again presented with paracentral corneal infiltrates. Sample from corneal scrapings grew a rare fungal pathogen, Colletotrichum species in potato dextrose agar. Topical steroids were withdrawn and keratitis was treated aggressively with hourly topical natamycin and itraconazole. Lesions resolved completely in next 3 weeks. This report highlights the fact that high suspicion of infectious sclerokeratitis is essential in young children and prompt medical treatment after diagnosis can have good prognosis.
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