DR.PRATIK BHAORA

Dr.Smruti Rekha Priyadarshini

Abstract

Pythium insidiosum is an aquatic oomycota found in soil and water. It presents as dense grey-white infiltrate with feathery margins, tentacle like extensions, and surrounding dot like infiltrates. A 66 years old male presented with 20 days history of pain, redness and watering in right eye following accidental injury with rice grain. Slit lamp examination showed presence of epithelial defect of 8 x 5 mm, infiltrate 6 x 4.5 mm, margins showing fine tentacle like extensions with surrounding deep pin head infiltrates and hypopyon of 2.2 mm. Microbiological examination of the corneal scrapings revealed Gram-positive filaments and presence of broad, sparsely septate, ribbon-like filaments on KOH-Calcofluor white stain. Iodine-potassium-iodide-H2SO4 stain showed bluish black filaments. Diagnosis of Pythium keratitis was made and patient was advised topical linezolid 0.2% eye drops hourly, atropine 1% eye drops TID but ulcer worsened and required therapeutic penetrating keratoplasty.