In December 2024, three patients in New York City developed severe Purpureocillium lilacinum keratitis after laser eye surgery at an ophthalmology clinic. Patients presented with eye pain and vision loss, with one requiring corneal transplantation. Diagnosis was confirmed by corneal cultures growing P. lilacinum, an environmental mold. An investigation revealed multiple infection prevention and control deficiencies at the clinic, including unapproved disinfectants, expired medications, and cool-mist humidifiers, which are discouraged in healthcare settings. Fungal amplicon sequencing detected P. lilacinum DNA in epikeratome suction tubing. No further cases occurred after implementing IPC measures.
Key note: Strict adherence to infection prevention and control guidelines in ambulatory settings is crucial to prevent healthcare-associated infections.