Analysis of 105 cases of fungal keratitis in Suwan Area

Abstract

Objective To analyze the epidemiological characteristics and treatment of fungal keratitis in Suwan Area. Methods The clinical data of 105 eyes of 105 patients with fungal keratitis from Jan.2012 to Dec.2017 were collected. The epidemiological, distribution characteristics and therapeutic schedules were analyzed retrospectively. Results All cases were monocular disease, including 53 cases (50.5%) in the left eye and 52 cases (49.5%) in the right. There were 70 (66.7%) males, 35 (33.3%) females, and the age was≥40 years in 92 cases (87.6%). There were 59 cases (56.2%) with clear history of trauma, 16 cases (15.2%) with other causes, and 30 patients (28.5%) without obvious cause.Seven patients (6.7%) were newly diagnosed and 98 cases (93.3%) were referred by the external hospital. Of the referrals, 24 cases were given antifungal treatment, 41 cases were given antibacterial, viral, or glucosteroids therapy, and 33 cases were given unknown treatment.There were 70 positive (66.7%) fungus cultrues, among which 29 cases (41.4%) with Fusarium, 18 cases (25.7%) with Aspergillus, 5 cases (7.1%) with Penicillium and 5 cases (7.1%) with Acremoniumin, 4 cases (5.7%) with Alternaria alternata, 3 cases (4.3%) with Curvularia spp, 2 cases(2.9%) with Mucor fungus and hybrid bacterium in 4 cases (11.4%). Forty-six cases (43.8%) were improved through antifungal drug treatment, 8 cases (7.6%) were aggravated and treated with ulcers debridement, 37 cases (35.2%) had infection controled through operation of corneal debridement combined with conjunctival flap coverage. Drugs or debridement were ineffective in 10 cases (9.5%) of corneal transplants.Four cases (3.8%) with uncontrolled infection received eyeball enucleation. Conclusion The main cause of fungal keratitis in Suwan Area is trauma. The main pathogens are Fusarium and Aspergillus. Key words: Keratitis, fungal; Suwan Area; Epidemiology