{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T18:39:33Z","timestamp":1784227173170,"version":"3.55.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003790","name":"Hiroshima University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003790","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Mycopathologia"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This report describes two cases of\n                    <jats:italic>Curvularia geniculata<\/jats:italic>\n                    keratitis, a rare form of fungal keratitis successfully managed with natamycin-based therapy. Both patients presented with characteristic feathery corneal infiltrates following ocular trauma. In vivo confocal microscopy and direct microscopy revealed septate filamentous fungi, and the isolates were definitively identified as\n                    <jats:italic>C. geniculata<\/jats:italic>\n                    through sequence analysis of the translation elongation factor 1-alpha (\n                    <jats:italic>tef1-\u03b1<\/jats:italic>\n                    ) gene. Antifungal susceptibility testing showed sensitivity to natamycin at 2\u00a0\u03bcg\/mL for both isolates, with variable sensitivity to other antifungal agents. Patient 1 was treated with a combination of topical natamycin and voriconazole, while Patient 2 received natamycin monotherapy. Both patients achieved complete healing and excellent visual outcomes. These cases underscore the importance of accurate molecular identification for species differentiation within the\n                    <jats:italic>Curvularia<\/jats:italic>\n                    genus and demonstrate the efficacy of natamycin-based therapy for\n                    <jats:italic>C. geniculata<\/jats:italic>\n                    keratitis. The choice between monotherapy and combination therapy may be guided by clinical severity and antifungal susceptibility testing. This report contributes to the understanding of the clinical features, diagnosis, and management of this rare condition and highlights the potential value of susceptibility testing in guiding treatment decisions.\n                  <\/jats:p>","DOI":"10.1007\/s11046-025-00997-9","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T09:11:38Z","timestamp":1757754698000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Two Cases of Curvularia geniculata Keratitis Successfully Treated with Natamycin-Based Therapy"],"prefix":"10.1007","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0539-884X","authenticated-orcid":false,"given":"Atsuhiko","family":"Fukuto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiya","family":"Miyako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinori","family":"Hara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Nagaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Sakaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiichiro","family":"Chikama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,13]]},"reference":[{"issue":"10","key":"997_CR1","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.3390\/jof8101067","volume":"8","author":"JJ Hoffman","year":"2022","unstructured":"Hoffman JJ, Arunga S, Mohamed Ahmed AHA, Hu VH, Burton MJ. Management of filamentous fungal keratitis: a pragmatic approach. J Fungi. 2022;8(10):1067. https:\/\/doi.org\/10.3390\/jof8101067.","journal-title":"J Fungi"},{"issue":"4","key":"997_CR2","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1111\/jam.15008","volume":"131","author":"M Rai","year":"2021","unstructured":"Rai M, Ingle AP, Ingle P, Gupta I, Mobin M, Bonifaz A, et al. Recent advances on mycotic keratitis caused by dematiaceous hyphomycetes. J Appl Microbiol. 2021;131(4):1652\u201367. https:\/\/doi.org\/10.1111\/jam.15008.","journal-title":"J Appl Microbiol"},{"key":"997_CR3","volume-title":"Reference method for broth dilution antifungal susceptibility testing of filamentous fungi, M38","author":"BD Alexander","year":"2017","unstructured":"Alexander BD, Dufresne P, Espinel-Ingroff A, Fuller J, Ghannoum MA, Hanson KE, et al. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi, M38. 3rd ed. Pennsylvania: Clinical and Laboratory Standards Institute; 2017.","edition":"3"},{"key":"997_CR4","first-page":"234","volume":"33","author":"LK Georg","year":"1964","unstructured":"Georg LK. Curvularia geniculata, a cause of mycotic keratits. J Med Assoc State Ala. 1964;33:234\u20136.","journal-title":"J Med Assoc State Ala"},{"key":"997_CR5","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1001\/archopht.1964.00970010472003","volume":"71","author":"K Nityananda","year":"1964","unstructured":"Nityananda K, Sivasubramaniam P, Ajello L. A case of mycotic keratitis caused by Curvularia geniculata. Arch Ophthalmol (Chicago, Ill: 1960). 1964;71:456\u20138. https:\/\/doi.org\/10.1001\/archopht.1964.00970010472003.","journal-title":"Arch Ophthalmol (Chicago, Ill: 1960)"},{"key":"997_CR6","first-page":"111","volume":"99","author":"KR Wilhelmus","year":"2001","unstructured":"Wilhelmus KR, Jones DB. Curvularia keratitis. Trans Am Ophthalmol Soc. 2001;99:111\u201330 (discussion 30\u20132).","journal-title":"Trans Am Ophthalmol Soc"},{"issue":"10","key":"997_CR7","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.4103\/ijo.IJO_90_20","volume":"68","author":"A Khurana","year":"2020","unstructured":"Khurana A, Chanda S, Bhagat P, Aggarwal S, Sharma M, Chauhan L. Clinical characteristics, predisposing factors, and treatment outcome of Curvularia keratitis. Indian J Ophthalmol. 2020;68(10):2088\u201393. https:\/\/doi.org\/10.4103\/ijo.IJO_90_20.","journal-title":"Indian J Ophthalmol"},{"key":"997_CR8","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens9010009","author":"N Kiss","year":"2019","unstructured":"Kiss N, Homa M, Manikandan P, Mythili A, Krizsan K, Revathi R, et al. New species of the genus Curvularia: C. tamilnaduensis and C. coimbatorensis from fungal keratitis cases in South India. Pathogens. 2019. https:\/\/doi.org\/10.3390\/pathogens9010009.","journal-title":"Pathogens"},{"key":"997_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3897\/mycokeys.68.51667","volume":"68","author":"I Iturrieta-Gonzalez","year":"2020","unstructured":"Iturrieta-Gonzalez I, Gene J, Wiederhold N, Garcia D. Three new Curvularia species from clinical and environmental sources. MycoKeys. 2020;68:1\u201321. https:\/\/doi.org\/10.3897\/mycokeys.68.51667.","journal-title":"MycoKeys"},{"issue":"4","key":"997_CR10","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1007\/s11557-021-01681-0","volume":"20","author":"HS Ferdinandez","year":"2021","unstructured":"Ferdinandez HS, Manamgoda DS, Udayanga D, Deshappriya N, Munasinghe MS, Castlebury LA. Molecular phylogeny and morphology reveal three novel species of Curvularia (Pleosporales, Pleosporaceae) associated with cereal crops and weedy grass hosts. Mycol Progress. 2021;20(4):431\u201351. https:\/\/doi.org\/10.1007\/s11557-021-01681-0.","journal-title":"Mycol Progress"},{"key":"997_CR11","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3767\/003158514X683538","volume":"33","author":"H Madrid","year":"2014","unstructured":"Madrid H, da Cunha KC, Gene J, Dijksterhuis J, Cano J, Sutton DA, et al. Novel Curvularia species from clinical specimens. Persoonia. 2014;33:48\u201360. https:\/\/doi.org\/10.3767\/003158514X683538.","journal-title":"Persoonia"},{"key":"997_CR12","doi-asserted-by":"publisher","first-page":"261","DOI":"10.3767\/persoonia.2022.49.08","volume":"49","author":"YP Tan","year":"2022","unstructured":"Tan YP, Bishop-Hurley SL, Shivas RG, Cowan DA, Maggs-Kolling G, Maharachchikumbura SSN, et al. Fungal planet description sheets: 1436\u20131477. Persoonia. 2022;49:261\u2013350. https:\/\/doi.org\/10.3767\/persoonia.2022.49.08.","journal-title":"Persoonia"},{"issue":"3","key":"997_CR13","doi-asserted-by":"publisher","first-page":"597","DOI":"10.3980\/j.issn.2222-3959.2015.03.29","volume":"8","author":"S Qiu","year":"2015","unstructured":"Qiu S, Zhao GQ, Lin J, Wang X, Hu LT, Du ZD, et al. Natamycin in the treatment of fungal keratitis: a systematic review and meta-analysis. Int J Ophthalmol. 2015;8(3):597\u2013602. https:\/\/doi.org\/10.3980\/j.issn.2222-3959.2015.03.29.","journal-title":"Int J Ophthalmol"},{"issue":"8","key":"997_CR14","doi-asserted-by":"publisher","first-page":"3332","DOI":"10.1007\/s12325-023-02541-x","volume":"40","author":"M Mascarenhas","year":"2023","unstructured":"Mascarenhas M, Chaudhari P, Lewis SA. Natamycin ocular delivery: challenges and advancements in ocular therapeutics. Adv Ther. 2023;40(8):3332\u201359. https:\/\/doi.org\/10.1007\/s12325-023-02541-x.","journal-title":"Adv Ther"},{"issue":"4","key":"997_CR15","doi-asserted-by":"publisher","first-page":"CD004241","DOI":"10.1002\/14651858.CD004241.pub4","volume":"2015","author":"NV FlorCruz","year":"2015","unstructured":"FlorCruz NV, Evans JR. Medical interventions for fungal keratitis. Cochrane Database Syst Rev. 2015;2015(4):CD004241. https:\/\/doi.org\/10.1002\/14651858.CD004241.pub4.","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"997_CR16","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1136\/bjophthalmol-2017-310683","volume":"102","author":"S Sradhanjali","year":"2018","unstructured":"Sradhanjali S, Yein B, Sharma S, Das S. In vitro synergy of natamycin and voriconazole against clinical isolates of Fusarium, Candida, Aspergillus and Curvularia spp. Br J Ophthalmol. 2018;102(1):142\u20135. https:\/\/doi.org\/10.1136\/bjophthalmol-2017-310683.","journal-title":"Br J Ophthalmol"}],"container-title":["Mycopathologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11046-025-00997-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11046-025-00997-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11046-025-00997-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T12:06:03Z","timestamp":1758974763000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11046-025-00997-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,13]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["997"],"URL":"https:\/\/doi.org\/10.1007\/s11046-025-00997-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7048594\/v1","asserted-by":"object"}]},"ISSN":["0301-486X","1573-0832"],"issn-type":[{"value":"0301-486X","type":"print"},{"value":"1573-0832","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,13]]},"assertion":[{"value":"4 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patients for the publication of this case report and any accompanying images.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"Written informed consent was obtained from the patients before the procedures described in this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Treatment"}},{"value":"This study was an observational study. The Institutional Review Board of Hiroshima University issued approval E2016-0709.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}],"article-number":"84"}}