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Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study
M Jayahar Bharathi1, R Ramakrishnan, Samala Vasu
1Department of Microbiology, Aravind Eye Care System, Tirunelveli, Tamil Nadu, India. aravind@tvl.aravind.org
Purpose:
To study the epidemiological characteristics and laboratory diagnosis of fungal keratitis seen at a tertiary eye care referral centre in South India.
Methods:
A retrospective review of all culture-proven fungal keratitis seen over a 3-year period, September 1999 through August 2002.
Results:
Fungal aetiology were confirmed in 1095 (34.4%) of 3183 corneal ulcers. The predominant fungal species isolated was Fusarium spp (471; 42.82%) followed by Aspergillus spp (286; 26%). Males (712; 65.08%) were more often affected (P<0.0001). A large proportion of the patients (732; 66.85%) were in the younger age group (21 to 50 years). A majority (879; 80.27%) came from rural areas (P<0.0001), and most patients (709; 64.75%) were farmers (P<0.0001). Ocular trauma (1009; 92.15%) was a highly significant risk factor (P<0.0001) and vegetative injuries (671; 61.28%) were identified as a significant cause for fungal keratitis (P<0.0001). 172 (15.71%) patients had concurrent diabetes mellitus. The sensitivity of 10% potassium hydroxide (KOH) wet mount preparation was higher (99.23%) than Gram-stained smear (88.73%) (P<0.0001). Incidence of fungal keratitis was higher between June and September.
Conclusion:
Agricultural activity and related ocular trauma were principal causes of mycotic keratitis. A potassium hydroxide (KOH) wet mount preparation is a simple, and sensitive, method for diagnosis
