An unusual case of Candida parapsilosis causing infectious crystalline keratopathy in Steven–Johnson syndrome

Abstract

A 41-year-old female, a known case of Steven–Johnson syndrome (SJS) with ocular involvement, had a pthisical right eye (RE) and a history of mucous membrane grafting (MMG) in the left eye. Two weeks post-MMG, the patient developed a pearly white crystalline anterior stromal infiltrate suggestive of infectious crystalline keratopathy (ICK). The Gram stain showed gram-positive, round-to-oval budding cells and the culture on sheep blood agar showed smooth white yeast colonies. VITEK 2 compact automated microbiology system-enabled species-level identification was Candida parapsilosis in addition to the antifungal sensitivity. Based on the sensitivity report, the patient responded well to oral fluconazole and topical voriconazole with corneal scar formation. Clinical and microbiological evaluations of ICK in an unusual setting like SJS is prudent for a successful outcome.