{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:17:59Z","timestamp":1790983079369,"version":"4.1.0"},"reference-count":17,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Fungal keratitis is a vision-threatening corneal infection, most commonly caused by\u00a0Fusarium\u00a0and Aspergillus. We report a rare case of keratitis caused by\u00a0Colletotrichum coccodes\u00a0in an elderly patient with a chronic corneal ulcer refractory to fluconazole. Initial corneal scrapings were negative, delaying diagnosis. Repeat deep biopsy, fungal culture and pan-fungal polymerase chain reaction confirmed\u00a0C. coccodes. The patient was managed with intensive topical amphotericin B and voriconazole, alongside a glycerol-preserved corneal patch graft to provide tectonic support.\nContribution:\u00a0This case highlights the diagnostic and therapeutic challenges of chronic fungal keratitis and illustrates the limitations of empiric antifungal therapy in the absence of culture-based guidance.<\/jats:p>","DOI":"10.4102\/sajid.v41i1.809","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:44:31Z","timestamp":1783604671000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Rare case of Colletotrichum coccodes causing chronic fungal keratitis in an elderly female: Diagnostic delay and antifungal resistance"],"prefix":"10.4102","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0678-5097","authenticated-orcid":false,"given":"Karabo","family":"Mathosa","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00c879s84","id-type":"ROR","asserted-by":"publisher"}],"name":"Groote Schuur Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Thomas PA, Kaliamurthy J. Mycotic keratitis: Epidemiology, diagnosis and management. Clin Microbiol Infect. 2013;19(3):210\u2013220. https:\/\/doi.org\/10.1111\/1469-0691.12126","DOI":"10.1111\/1469-0691.12126"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN. The epidemiological features and laboratory results of fungal keratitis: A 10-year review at a referral eye care center in South India. Cornea. 2002;21(6):555\u2013559. https:\/\/doi.org\/10.1097\/00003226-200208000-00004","DOI":"10.1097\/00003226-200208000-00004"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Buchta V, Nekolov\u00e1 J, Jir\u00e1skov\u00e1 N, Bolehovsk\u00e1 R, Wipler J, Hubka V. Fungal keratitis caused by Colletotrichum dematium: Case study and review. Mycopathologia. 2019;184:441\u2013453.","DOI":"10.1007\/s11046-019-00335-w"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Palaniappan R. Clinical characteristics and laboratory diagnosis of fungal keratitis. Ophthalmic Res. 2007;39(1):1\u20137. https:\/\/doi.org\/10.1159\/000096621.","DOI":"10.1159\/000096621"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Rautaraya B, Sharma S, Kar S, et al. Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern India. BMC Ophthalmol. 2011;11:39. https:\/\/doi.org\/10.1186\/1471-2415-11-39.","DOI":"10.1186\/1471-2415-11-39"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Kotwal A, Biswas D, Kakati B, et al. Non traumatic keratitis due to Colletotrichum coccodes: A case report. J Clin Diagn Res. 2015;9(2):DD01\u2013DD02.","DOI":"10.7860\/JCDR\/2015\/10843.5529"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Srinivasan M. Fungal keratitis. Curr Opin Ophthalmol. 2004;15(4):321\u2013327. https:\/\/doi.org\/10.1097\/00055735-200408000-00008","DOI":"10.1097\/00055735-200408000-00008"},{"key":"ref7","unstructured":"Sutton DA. Speciation of Colletotrichum spp.: Limitations of morphology. J Clin Microbiol. 1992;30:2460\u20132465."},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Vengayil S, Panda A, Satpathy G, et al. Polymerase chain reaction-guided diagnosis of mycotic keratitis: A prospective evaluation of its efficacy and limitations. Invest Ophthalmol Vis Sci. 2009;50(1):152\u2013156. https:\/\/doi.org\/10.1167\/iovs.07-1283","DOI":"10.1167\/iovs.07-1283"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Ansari Z, Miller D, Galor A. Current thoughts in fungal keratitis: Diagnosis and treatment. Curr Fungal Infect Rep. 2013;7:209\u2013218.","DOI":"10.1007\/s12281-013-0150-1"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Ti SE, Scott JA, Janardhanan P, Tan DT. Therapeutic keratoplasty for advanced suppurative keratitis. Am J Ophthalmol. 2007;143(5):755\u2013762. https:\/\/doi.org\/10.1016\/j.ajo.2007.01.015","DOI":"10.1016\/j.ajo.2007.01.015"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Prajna VN, Krishnan T, Mascarenhas J, et al. The mycotic ulcer treatment trial: A randomized trial comparing natamycin vs voriconazole. JAMA Ophthalmology. 2013;131(4):422\u2013429.","DOI":"10.1001\/jamaophthalmol.2013.1497"},{"key":"ref12","unstructured":"Chidambaram JD, Prajna NV, Srikanthi P, et al. Characteristics of filamentous fungal keratitis. Br J Ophthalmol. 2018;102:1235\u20131240."},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Zhao H, He Y, Ren YR, Chen BH. Corneal alteration and pathogenesis in diabetes mellitus. Int J Ophthalmol. 2019;12(12):1939\u20131950.","DOI":"10.18240\/ijo.2019.12.17"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Raj N, Vanathi M, Gokhale NS, et al. Recent perspectives in the management of fungal keratitis. J Fungi (Basel). 2021;7(11):907. https:\/\/doi.org\/10.3390\/jof7110907.","DOI":"10.3390\/jof7110907"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Xie L, Shi W, Liu Z, et al. Lamellar keratoplasty for the treatment of fungal keratitis. Cornea. 2002;21(1):33\u201337.","DOI":"10.1097\/00003226-200201000-00008"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Sharma N, Sahay P, Maharana PK, et al. Management Algorithm for Fungal Keratitis: The TST (Topical, Systemic, and Targeted Therapy) Protocol. Cornea. 2019;38(2):141\u2013145. https:\/\/doi.org\/10.1097\/ICO.0000000000001781","DOI":"10.1097\/ICO.0000000000001781"}],"container-title":["Southern African Journal of Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/sajid.co.za\/index.php\/sajid\/article\/view\/809\/2128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:44:39Z","timestamp":1783604679000},"score":1,"resource":{"primary":{"URL":"https:\/\/sajid.co.za\/index.php\/sajid\/article\/view\/809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/sajid.v41i1.809","relation":{},"ISSN":["2312-0053","2313-1810"],"issn-type":[{"value":"2312-0053","type":"print"},{"value":"2313-1810","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"article-number":"a809"}}