Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study

Abstract

Objective: Corneal blindness is a major public health problem worldwide and mycotic keratitis is one of the predominant causes. Infection is difficult to treat and can lead to severe visual impairment or blindness. It is worldwide in distribution but is more common in tropics and subtropical region. Trauma is the major predisposing factor, followed by ocular or systemic defects, prior application of corticosteroids, and prolonged use of antibiotic eye drops. The purpose of this study was to document the clinical and epidemiological features and laboratory diagnosis of fungal corneal ulcer. Methods: Patients who presented with clinically suspected corneal ulcer to ophthalmology department registered for the study. Data were collected through history and slit lamp examination. Corneal scrapping was performed. A portion of each scrapping was examined by direct microscopy. Another portion was inoculated directly on to solid culture media. Results: This study included 40 subjects with corneal ulcer based on clinical suspicion, of whom 14 cases were diagnosed with mycotic keratitis in the laboratory. Among these 14 cases, culture showed fungal growth only in 12 cases where the remaining cases were positive only by Potassium hydroxide (KOH) preparation. Males were more commonly affected and were mostly in the age group of 21 to 50 years. Aspergillus species and Fusarium species were the major isolates. Conclusion: Rapid diagnosis and early institution of anti-fungal therapy is necessary to prevent ocular morbidity and blindness. The direct microscopy method by KOH is rapid, inexpensive and reliable method and culture helps in definite diagnosis and identification.

Clinical Profile and Evaluation of Topical Voriconazole for Management of Fungal Corneal Ulcer in North Western Rajasthan

“…Male: female ratio was 3:2. Similar results were found in a study done by Tukaram et al 7 where 24 cases (60%) were males and 16 (40%) were females. Our results also correlated with the study by Gopinathan et al 8 , who also reported that males (962) were affected more significantly (p < 0.0001) than females (390).…”

Epidemiological Characteristics and Laboratory Diagnosis of Fungal Keratitis in Patients with Corneal Ulcer in Riyadh, Saudi Arabia

“…These results are nearly similar to those reported by Gopinathan et al (2002) who found that the males were significantly more frequently affected than females (a ratio of 2.5:1). Also Kalshetti et al(2015) found that from 40 patients only 24(60%) were males and 16(40%) were females. 64% of patients were in the age group 20 to 50 years (Tilak etal.…”

“…Previous report recorded (42.9%) patients with fungal keratitis were farmers; one (14.3%) animal husbandman, one (14.3%) laborer, and 2 (28.6%) were housewives (Shokohiet al1999). Kalshetti et al (2015) reported that seven (50%) patients with fungal keratitis were farmers, three (21.4%) laborer and four (28.5%) were housewives.…”

“…with frequency (44. Aspergillus species (06) and Fusarium species (05) were the major isolates in the study of Kalshetti et al (2015). Filamentous fungi were isolated in 85.7% cases of fungal keratitis.…”

An Overview of Prevalence and Treatment of Mycotic Keratitis in India and other Countries in the Indian Subcontinent

“…More recently, a prospective study on 40 patients with corneal ulcer was conducted over a 25 month period (October 2011 to November 2013) at a medical college in Dhule, northern Maharashtra [Kalshetti et al, 2015]. Microbiological tests on corneal scrapings from the patients confirmed a diagnosis of mycotic keratitis in 14; fungal growth in culture was obtained in 12 cases, while the other two were positive only by KOH preparation.…”