Mycotic keratitis in India: a five-year retrospective study.
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.


METHODS
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.


CONCLUSIONS
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.
Tilak
Ragini
R
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. raginijain29@rediffmail.com
Singh
Abhisek
A
Maurya
Om Prakash Singh
OP
Chandra
Abhishek
A
Tilak
Vijai
V
Gulati
Anil Kumar
AK
D000328:Adult; D000367:Age Factors; D001228:Aspergillosis / Q000209:etiology / Q000473:pathology; D001231:Aspergillus flavus / Q000302:isolation & purification; D001706:Biopsy / Q000379:methods; D003315:Cornea / Q000382:microbiology / Q000473:pathology; D015821:Eye Infections, Fungal / Q000209:etiology* / Q000473:pathology; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D006878:Hydroxides; D007194:India; D007202:Indicators and Reagents; D007634:Keratitis / Q000209:etiology* / Q000473:pathology; D008297:Male; D017680:Potassium Compounds; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
D006878:Hydroxides; D007202:Indicators and Reagents; D017680:Potassium Compounds; C029943:potassium hydroxide