Purpureocillium lilacinum Keratitis Outbreak Associated with an Ophthalmology Clinic — New York City, 2024

In December 2024, a clinical laboratory notified the New York City Health Department of three patients with fungal keratitis caused by an unidentified mold following laser eye surgery at an ophthalmology clinic. All three patients experienced vision loss, and one patient required corneal transplantation. Corneal cultures from two of the patients grew Purpureocillium lilacinum, an environmental mold that can cause a range of infections in humans; eye infections have been reported. The clinic paused surgeries. The health department assessed the clinic's infection prevention and control (IPC) practices and identified multiple deficiencies, including incomplete instrument sterilization logs, absence of disinfectants approved for use on work surfaces, use of expired topical ocular medications, and opportunities for exposure to nonsterile water from cool-mist humidifiers in the procedure room. CDC environmental infection control guidelines recommend avoidance of cool-mist humidifiers in health care facilities. All environmental cultures were negative for P. lilacinum, but fungal amplicon sequencing detected P. lilacinum DNA in the tubing of a surgical device. No further cases were identified after implementation of recommended IPC measures and resumption of surgeries during January 2025. Adherence to published IPC guidance during all procedures in ambulatory settings can reduce the risk for health care-associated infections.