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Equine Fungal Keratitis due to Cladorrhinum bulbillosum.
Abstract: To describe the case details and treatment of an equine fungal keratitis case caused by Cladorrhinum bulbillosum. Methods: A 14-year-old Bashkir Curly gelding with a complicated corneal ulcer of the left eye. Methods: Corneal cytology was performed, and intraoperative samples were collected for polymerase chain reaction and for aerobic and mycologic cultures. Under general anesthesia, an inferior eyelid subpalpebral lavage system (SPL) was placed to facilitate postoperative therapy. Anterior stromal keratectomy was performed followed by cryotherapy of the keratectomy bed. A biological scaffold graft was secured within the defect and temporary tarsorrhaphy performed to protect the surgical site. Postoperatively, the horse received systemic anti-inflammatories and topical medications via SPL: antibacterials (ofloxacin, cefazolin), antifungals (voriconazole, luliconazole), and anticollagenase (serum) as well as atropine. Reevaluations were performed every 2-3 weeks until discontinuation of medications. Results: Following surgical and medical management, the horse showed improvement with resolution of the corneal ulcer over an 8-week treatment period. Next-generation sequencing identified C. bulbillosum as the predominant organism, and fungal culture supported filamentous fungal infection. Conclusions: C. bulbillosum infection caused equine fungal keratitis in this case. The use of topical voriconazole and luliconazole, combined with surgical intervention (keratectomy, cryotherapy, bio scaffold graft), resulted in a good response. The corneal ulcer healed well with minor scarring over 8 weeks following surgical intervention. To the authors' knowledge, this was the second report of equine fungal keratitis caused by C. bulbillosum. This case highlights the utility of next-generation DNA sequencing and multimodal treatment with adjunctive contemporary therapies.
© 2026 The Author(s). Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.
Publication Date: 2026-08-17 PubMed ID: 42608345PubMed Central: PMC13481282DOI: 10.1111/vop.70249Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
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Summary
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Overview
- This research article presents a detailed case study of fungal keratitis in a horse caused by the rare fungus Cladorrhinum bulbillosum, focusing on diagnosis, treatment, and successful recovery using surgical and topical therapies.
Introduction and Case Background
- A 14-year-old Bashkir Curly gelding horse developed a complicated corneal ulcer in the left eye.
- Fungal keratitis is an infection of the cornea caused by fungi, which can be difficult to diagnose and treat due to the fungal organism’s nature and corneal sensitivity.
- The fungus identified was Cladorrhinum bulbillosum, a rarely reported cause of equine fungal eye infections, marking this as the second documented case.
Diagnostic Methods
- Corneal cytology was performed initially to assess the cells and presence of infection in the corneal ulcer.
- Intraoperative samples were collected for:
- Polymerase chain reaction (PCR) to amplify fungal DNA and identify the causative organism.
- Aerobic cultures to check for bacterial infection.
- Mycologic cultures to grow and confirm fungal presence.
- Next-generation DNA sequencing was used, which helped identify C. bulbillosum as the primary fungal pathogen involved.
Treatment Approach
- Surgical intervention was necessary due to the complicated nature of the corneal ulcer:
- Anterior stromal keratectomy: surgical removal of the diseased corneal tissue.
- Cryotherapy was applied to the keratectomy bed to destroy residual infected cells and limit fungal growth.
- A biological scaffold graft was placed into the corneal defect to support healing.
- Temporary tarsorrhaphy (partial eyelid closure) was performed to protect the surgical site during recovery.
- To facilitate medication delivery, an inferior eyelid subpalpebral lavage system (SPL) was placed under general anesthesia, enabling easy administration of topical drugs postoperatively.
- Medical management included systemic anti-inflammatory drugs and topical therapies delivered via SPL:
- Antibacterials: ofloxacin and cefazolin to prevent or treat secondary bacterial infections.
- Antifungals: voriconazole and luliconazole targeted the fungal infection effectively.
- Anticollagenase agents (serum) to inhibit corneal degradation enzymes.
- Atropine to dilate the pupil and relieve pain.
Outcome and Significance
- The combined surgical and medical treatment led to the resolution of the corneal ulcer over approximately 8 weeks.
- The corneal healing was successful with only minor scarring, which is a positive outcome considering the severity of fungal keratitis.
- The case emphasizes:
- The importance of using advanced diagnostic tools like next-generation sequencing to accurately identify rare fungal pathogens.
- The benefits of multimodal treatment—combining surgery, cryotherapy, grafting, and broad-spectrum topical antifungals and antibacterials—for complex equine fungal keratitis.
- The effectiveness of contemporary adjunctive therapies enabling better recovery and preservation of vision in horses affected by fungal corneal infections.
- This study adds valuable clinical knowledge as one of the very few reports linking Cladorrhinum bulbillosum to equine fungal keratitis, guiding veterinarians in similar future cases.
Cite This Article
APA
Hamilton A, Lacy L, Scherrer N.
(2026).
Equine Fungal Keratitis due to Cladorrhinum bulbillosum.
Vet Ophthalmol, 29(5), e70249.
https://doi.org/10.1111/vop.70249 Publication
Researcher Affiliations
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA.
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA.
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA.
MeSH Terms
- Animals
- Horses
- Horse Diseases / microbiology
- Horse Diseases / drug therapy
- Horse Diseases / therapy
- Horse Diseases / surgery
- Horse Diseases / diagnosis
- Eye Infections, Fungal / veterinary
- Eye Infections, Fungal / microbiology
- Eye Infections, Fungal / drug therapy
- Eye Infections, Fungal / therapy
- Eye Infections, Fungal / diagnosis
- Male
- Antifungal Agents / therapeutic use
- Keratitis / veterinary
- Keratitis / microbiology
- Keratitis / drug therapy
- Corneal Ulcer / veterinary
- Corneal Ulcer / microbiology
Conflict of Interest Statement
The authors have not used AI to generate any part of the manuscript. The authors declare no conflicts of interest.
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