title: Mycotic corneal ulcers in upper Assam.
abstract: OBJECTIVE
  To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam.
  
  
  METHODS
  In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire.
  
  
  RESULTS
  In 188 (60.6%) cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%). The maximum (23.4%) cases were reported during the paddy harvesting season in Assam (January and February). Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH) mount. The commonest predisposing factor was corneal injury (74.5%). While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25%) was the commonest isolate followed by Aspergillus species (19%), Curvularia species (18.5%) and Penicillium species (15.2%). Yeasts were isolated in 2.7% (n=5) cases.
  
  
  CONCLUSIONS
  Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.
authors.affiliation: Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, India. reema_44@rediffmail.com
authors.forename: Reema
authors.initials: R
authors.lastname: Nath
authors.forename: Syamanta
authors.initials: S
authors.lastname: Baruah
authors.forename: Lahari
authors.initials: L
authors.lastname: Saikia
authors.forename: Bhanu
authors.initials: B
authors.lastname: Devi
authors.forename: A K
authors.initials: AK
authors.lastname: Borthakur
authors.forename: J
authors.initials: J
authors.lastname: Mahanta
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult