Clinical isolates and management

Dematiaceous fungi are darkly pigmented, filamentary moulds and are common in the environment as plant saprophytes and pathogens. Incidental reports of corneal ulcers that have been caused by species of this group have appeared in the literature, but the relative importance of this species as potential comeal pathogens has not been appreciated. As a group, second to Fusarium solani and other moniliaceous fungi, we find that dematiaceous fungi comprise the next most common cause of fungal ulcers in south Florida. The successful treatment of Fusarium solani keratitis with Natamycin (Pimaricin) has been reported by Jones, Forster, and Rebell (1972), and we have examined the management of other non-Fusarium solani moniliaceous fungal ulcers. The purpose of this communication is to report our study of I 6 isolates of dematiaceous fungal keratitis, their features, and management including nine cases that were treated with Natamycin, and to stress their relative clinical importance.