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Mycological profile of infectious Keratitis from Delhi
1Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India. rumpachatterjee@yahoo.co.in
Background & Objective:
Corneal blindness is a major health problem worldwide and infectious keratitis is one of the predominant causes. The incidence of fungal keratitis has increased over the last few years. Though a few studies have been carried out on mycotic keratitis from north and other parts of India, there are none from Delhi. Keeping this in mind, this study was conducted to evaluate the frequency of positive fungal cultures in infectious keratitis and of the various fungal species identified as aetiologic agents in patients attending a tertiary care hospital in East Delhi.
Methods:
Corneal scrapings from 346 patients of corneal ulcer with suspected fungal aetiology were subjected to direct examination by 10 per cent KOH mount, Gram stain and culture. The results were examined retrospectively and analyzed.
Results:
Of the 346 patients of corneal ulcer investigated, in 77 (22.25%) cases fungal aetiology was identified. Males were more commonly affected and were mostly in the age group of 31-40 yr. It was seen that trauma was the most common predisposing factor especially in the agriculturists and the farmers. Aspergillus flavus was the most common fungus isolated in 31.16 per cent cases, followed by A. fumigatus (16.88%) and Fusarium spp. (7.79%). Yeasts were also isolated in 21.62 per cent cases. Both yeasts and mycelial fungi were isolated in 6.5 per cent of cases.
Interpretation & Conclusion:
Because of serious consequences of infectious keratitis, it is important to know the exact aetiology of corneal ulcer to institute appropriate therapy in time. Laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing corticosteroids and antibacterial antibiotics.
Insights
Fungal keratitis is a significant cause of infectious corneal ulcers, with Aspergillus flavus being the most common pathogen identified in East Delhi. Early laboratory diagnosis is crucial for effective treatment and preventing vision loss.
Area of Science:
- Ophthalmology
- Medical Mycology
- Infectious Diseases
Background:
- Corneal blindness is a global health concern, with infectious keratitis being a leading cause.
- Fungal keratitis incidence is rising, necessitating regional etiological studies.
- No prior studies on fungal keratitis etiology existed for Delhi, India.
Purpose of the Study:
- To determine the frequency of fungal infections in infectious keratitis cases.
- To identify the specific fungal species causing keratitis in East Delhi.
- To analyze demographic and risk factors associated with fungal keratitis.
Main Methods:
- Retrospective analysis of 346 corneal ulcer patients with suspected fungal etiology.
- Corneal scrapings examined via 10% KOH mount, Gram stain, and fungal culture.
- Data on patient demographics, predisposing factors, and isolated fungi were analyzed.
Main Results:
- Fungal etiology was identified in 22.25% (77/346) of cases.
- Males aged 31-40 years were most affected, with trauma being a common predisposing factor, especially in agricultural workers.
- Aspergillus flavus (31.16%), A. fumigatus (16.88%), Fusarium spp. (7.79%), and yeasts (21.62%) were the predominant isolates.
Conclusions:
- Accurate etiological diagnosis of corneal ulcers is vital for timely and appropriate treatment.
- Fungal infection should be considered and ruled out before initiating corticosteroid or antibacterial therapy.
- Laboratory confirmation is essential for managing infectious keratitis effectively.
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