A study on mycological profile of corneal ulcers in a tertiary care hospital

Abstract

Introduction: Keratitis may be due to infectious or non-infectious etiology. Breach in the corneal epithelial barrier due to trauma or surgery predisposes to infectious keratitis which can result in scarring and blindness. The most common bacteria implicated is S.aureus. Among the fungi, Fusarium, Aspergillus and Candida spp., are common agents. The fungi are usually inoculated into the cornea by trauma involving plant or vegetable matter. This study was conducted to know the prevalence of fungal keratitis and the different fungal species implicated in patients attending our tertiary care hospital. Materials and Methods: Corneal scrapings collected under slit-lamp examination with aseptic precautions were subjected to KOH mount, Gram stain, inoculated on Sabouraud dextrose agar and sent to Microbiology lab for further processing using standard techniques. Result: Out of the 18 clinically suspected fungal keratitis cases studied, 7 (38.89%) were farmers and most common risk factor associated was trauma 66.66% (12/18) of which vegetative trauma accounted for 27.78% (5/18) cases. 10 (55.56%) cases were both KOH and culture positive. The prevalence of fungal keratitis in our study was 1.54%. Out of the 10 positive cultures, most common isolate was Candida albicans (40%). Conclusion: Fungal keratitis is an important cause of monocular blindness that occurs after trivial trauma to the eyes. Most of the patients do not come to the ophthalmologist immediately after such trauma due to lack of knowledge. Early diagnosis and prompt treatment if initiated in the early phase of the infection can prevent the occurrence of any complications. Keywords: Corneal ulcer, Mycotic Keratitis, Fusarium spp, Candida spp.