Acremonium keratomycosis in a cat

A 14-year-old, female spayed Domestic Short-haired cat was presented for evaluation of progressive superficial corneal ulceration with mucoid ocular discharge, blepharospasm, and conjunctival hyperemia OD. Upon examination, ulcerative keratitis with stromal loss, chemosis, corneal edema, miosis, aqueous flare, and hyphema were noted. Corneal cytology revealed branching, septate fungal hyphae with bulbous terminations and associated ovoid structures, with suppurative inflammation. Fungal culture of corneal swabs confirmed the presence of Acremonium, although PCR of the cytology sample was negative. Ten days of treatment with topical 1% miconazole resulted in clinical deterioration before switching to topical 1% voriconazole solution, which was successful in resolving the infection. The apparent clinical efficacy of the topical antifungals used contrasted with the in vitro susceptibility profile.