Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study.
OBJECTIVE
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.


CONCLUSIONS
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
Bharathi
M Jayahar
MJ
Department of Microbiology, Aravind Eye Care System, Tirunelveli, Tamil Nadu, India. aravind@tvl.aravind.org
Ramakrishnan
R
R
Vasu
Samala
S
Meenakshi
R
R
Palaniappan
R
R
D000328:Adult; D019411:Clinical Laboratory Techniques; D003941:Diagnostic Techniques, Ophthalmological; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007194:India / Q000453:epidemiology; D007634:Keratitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data