A Greek study has identified Macrophomina phaseolina, a fungal pathogen primarily affecting plants, as a rare but emerging cause of endophthalmitis in humans.

Researchers Drs Panagiotis Toumasis and Georgia Vrioni from the National and Kapodistrian University of Athens reported the first case of severe endophthalmitis caused by M. phaseolina in a 78-year-old man. Despite aggressive antifungal treatment, the infection led to enucleation.

Their literature review, published in Journal of Clinical Medicine, documented 13 known cases of M. phaseolina infections worldwide. Of these, 77% involved ocular infections, often associated with eye trauma. Nearly half of the affected patients experienced poor outcomes, they reported.

The review highlighted the diverse clinical presentations of M. phaseolina infections, ranging from superficial skin infections to invasive conditions including severe ocular disease.

Authors cautioned that timely diagnosis remains challenging due to the fungus’ rarity in clinical settings and the lack of standardised treatment guidelines. “However, early identification and appropriate antifungal therapy are critical for improving patient outcomes, particularly for vulnerable patients,” they said.