Clinical Characteristics and Treatment Outcomes of Fungal Endophthalmitis Caused by Neoscytalidium dimidiatum

Chunxia Qi,1,* Biyun Mo,1,* Changhong Jiang,2,* Jiali Li,3 Xuguang Bo,1 Xuhui Xiao,1 Hao Zhou,4 Jun Long1 1Department of Laboratory Medicine, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510000, People’s Republic of China; 2Quality Management Section, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510000, People’s Republic of China; 3Department of Ophthalmology, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510000, People’s Republic of China; 4Department of Hospital Infection Management, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hao Zhou, Department of Hospital Infection Management, ZhuJiang Hospital of Southern Medical University, 253 Industrial Avenue Zhong, Guangzhou, Guangdong, 510280, People’s Republic of China, Email [email protected] Jun Long, Department of Laboratory Medicine, ZhuJiang Hospital of Southern Medical University, 253 Industrial Avenue Zhong, Guangzhou, Guangdong, 510280, People’s Republic of China, Email [email protected]: Neoscytalidium dimidiatum (N. dimidiatum) is a common fungal pathogen that primarily affects plants but can also cause rare infections in humans. In recent years, sporadic cases have been reported worldwide. Here, we report the first case of endophthalmitis in China resulting from a corneal scratch caused by an infected dragon fruit. Exogenous fungal endophthalmitis can be classified into three categories: postoperative, post-traumatic, and keratitis-associated. Currently, there is no standardized antifungal regimen for N. dimidiatum infections, especially for endophthalmitis, where systemic antibiotics have poor intraocular penetration. Successful management often requires surgical interventions such as amputation or drainage. Our case highlights the diagnostic and therapeutic challenges, as well as the poor outcomes associated with N. dimidiatum infections in humans.Keywords: Neoscytalidium dimidiatum, infection, endophthalmitis, characteristics, treatment