title: Spectrum of fungal keratitis: clinicopathologic study of 44 cases.
abstract: OBJECTIVE
  To determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital.
  
  
  METHODS
  A retrospective analysis of fungal corneal ulcers was done from 2003-2012. Patients' clinical data were noted from the file records. Correlation of histopathological diagnosis was done with the report on fungal culture.
  
  
  RESULTS
  Mycotic keratitis was established in 44 cases by a positive fungal culture. Direct microscopic examination of potassium hydroxide (KOH) mounts revealed fungal elements in 39 cases while 40 cases showed fungus on Gram stained smears. Males (54.55%) were more commonly affected than the females (45.45%). The age ranged from 18 to 82 years. Most common age group to be involved was 41-60 years. Predisposing risk factors were seen in 34 (77.27%) cases. Most common findings on clinical examination were anterior chamber reaction and conjunctival injection seen in all the cases. Other common findings were stromal infiltration and hypopyon seen in 20 (45.45%) and 18 (40.91%) cases respectively. On histopathological examination the fungus was typed, as aspergillus in 34 cases while no definite typing was possible in 10 cases. The predominant isolate was aspergillus flavus (59.09%) followed by fusarium (15.91%). Mixed fungal and bacterial infection was seen in 3 (6.82%) cases.
  
  
  CONCLUSIONS
  Although culture is the gold standard for definitive diagnosis of fungal keratitis, direct microscopic examination of corneal scrapings or histomorphological evaluation of biopsies allow a rapid preliminary diagnosis. Early administration of antifungal treatment helps in preventing dreadful complications.
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India.
authors.forename: Rajpal Singh
authors.initials: RS
authors.lastname: Punia
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India.
authors.forename: Reetu
authors.initials: R
authors.lastname: Kundu
authors.affiliation: Department of Microbiology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India.
authors.forename: Jagdish
authors.initials: J
authors.lastname: Chander
authors.affiliation: Department of Ophthalmology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India.
authors.forename: Sudesh Kumar
authors.initials: SK
authors.lastname: Arya
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Handa
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India.
authors.forename: Harsh
authors.initials: H
authors.lastname: Mohan
keywords: cornea; culture; fungal; infection; mycotic keratitis