Fungal keratitis in Melbourne.
BACKGROUND
Description of the clinical and microbiological spectrum of fungal keratitis at a tertiary eye care hospital in Melbourne, Australia.


METHODS
Retrospective review of all patients with keratitis with positive fungal cultures from corneal or associated samples presenting to the Royal Victorian Eye and Ear Hospital, Melbourne, Australia from July 1996 to May 2004. Demographic data, predisposing factors, features on presentation, management, outcomes and microbiological data were collected and analysed.


RESULTS
The study included 56 eyes of 56 patients. Thirty-five patients were treated as 'typical' fungal keratitis and used for description and analysis, with a mean follow up of 18 months. Ocular trauma (37.1%), chronic steroid use (31.4%) and poor ocular surface (25.7%) were the major predisposing factors. Perforation was seen in 25.7% of patients, penetrating keratoplasty was required in 9 (25.7%) patients and evisceration was performed in 2 (5.7%) patients. Candida albicans (13 patients, 37.2%) was the most common fungal isolate accounting for more than one-third of all organisms followed by Aspergillus fumigatus (six patients, 17.1%) and Fusarium sp. (five patients, 14.3%).


CONCLUSIONS
The present study describes the clinical patterns of fungal keratitis in Melbourne, Australia and contrasts them with reports from other areas of the world. A high incidence of C. albicans infection and the prior use of steroids in high proportion of the patients are highlighted in this study.
Bhartiya
Prashant
P
Centre for Eye Research Australia, University of Melbourne, Mellbourne, Victoria, Australia.
Daniell
Mark
M
Constantinou
Marios
M
Islam
F M Amirul
FM
Taylor
Hugh R
HR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D002176:Candida albicans / Q000302:isolation & purification; D002648:Child; D003320:Corneal Ulcer / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D017234:Eye Evisceration; D015821:Eye Infections, Fungal / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology
D000935:Antifungal Agents