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Published on: May 12, 2020
Mycotic keratitis in India: a five-year retrospective study
Ragini Tilak1, Abhisek Singh, Om Prakash Singh Maurya
1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. raginijain29@rediffmail.com
Background:
Mycotic keratitis is a fungal infection of the cornea. This infection is difficult to treat and it can lead to severe visual impairment or blindness. It is worldwide in distribution, but is more common in the tropics and subtropical regions. Trauma is the major predisposing factor, followed by ocular and systemic defects, prior application of corticosteroids, and prolonged use of antibiotic eye-drops. The objective of this study was to determine causative agents and to identify the predisposing factors of mycotic keratitis.
Methodology:
Corneal scrapings from 90 corneal ulcer patients with suspected fungal etiology were subjected to direct examination by 10% KOH mount, Gram stain and culture.
Results:
This study included 90 subjects with corneal ulcers, based on clinical suspicion, of whom 41 cases were diagnosed with mycotic keratitis in the laboratory. Among these 41 cases, culture showed fungal growth only in 36 cases whereas the remaining five cases were positive only by potassium hydroxide (KOH) preparation. Males were more commonly affected and were mostly in the age group of 31-40 years. Aspergillus flavus was the most common fungus isolated followed by fusarium solani.
Conclusion:
Rapid diagnosis and early institution of antifungal therapy is necessary to prevent ocular morbidity and blindness. Although culture helps in definite diagnosis and identification, direct microscopic detection of fungal structures in corneal scrapes or biopsies permits a rapid presumptive diagnosis.
Insights
Mycotic keratitis, a serious fungal eye infection, was diagnosed in 41 of 90 patients. Aspergillus flavus and Fusarium solani were the most common causative agents, highlighting the need for rapid diagnosis.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Mycotic keratitis is a severe fungal corneal infection with global prevalence, particularly in tropical regions.
- It leads to significant visual impairment and blindness, often linked to trauma and prior ocular treatments.
- Predisposing factors include trauma, ocular/systemic defects, corticosteroid use, and prolonged antibiotic eye-drop application.
Purpose of the Study:
- To identify the causative fungal agents of mycotic keratitis.
- To determine the predisposing factors associated with this corneal infection.
Main Methods:
- Corneal scrapings from 90 patients with suspected fungal keratitis were analyzed.
- Diagnostic methods included 10% KOH mount, Gram stain, and fungal culture.
Main Results:
- Mycotic keratitis was diagnosed in 41 out of 90 patients.
- Fungal growth was confirmed by culture in 36 cases and by KOH preparation in 5 cases.
- Aspergillus flavus and Fusarium solani were the predominant fungal species identified; males aged 31-40 were most affected.
Conclusions:
- Rapid diagnosis and prompt antifungal treatment are crucial to prevent vision loss.
- Direct microscopic examination offers a faster presumptive diagnosis compared to culture alone.
