Abstract
Neoscytalidium dimidiatum (N. dimidiatum) is a common fungal pathogen that primarily affects plants but can also cause rare infections in humans. In recent years, sporadic cases have been reported worldwide. Here, we report the first case of endophthalmitis in China resulting from a corneal scratch caused by an infected dragon fruit. Exogenous fungal endophthalmitis can be classified into three categories: postoperative, post-traumatic, and keratitis-associated. Currently, there is no standardized antifungal regimen for N. dimidiatum infections, especially for endophthalmitis, where systemic antibiotics have poor intraocular penetration. Successful management often requires surgical interventions such as amputation or drainage. Our case highlights the diagnostic and therapeutic challenges, as well as the poor outcomes associated with N. dimidiatum infections in humans.