Comparison of mycotic keratitis with nonmycotic keratitis: an epidemiological study.

Mohammad M Khater,Nehal S Shehab,Anwar S El-Badry

doi:10.1155/2014/254302

Abstract

Purpose. This work aims to study the problems encountered with and the different epidemiological features of patients with fungal keratitis. Patients and Methods. All cases with keratitis attending the Outpatient Clinic of Ophthalmology Department at Tanta University Hospital during three years from the first of January 2011 to the end of December 2013 were selected and carefully examined and cases with mycotic keratitis were further examined and investigated. Results. From 66303 attendants during this period with different complaints, there were 361 cases (0.54%) with mycotic keratitis and 473 cases (0.71%) of nonmycotic origin. Mycotic keratitis is common between 40 and 60 years, more in farmers (64%), families with large number and large crowding index, rural than urban residence, and patients with outdoor water sources and insanitary sewage disposal. Positive fungal cultures were obtained in 84.5% and were negative in 15.5% of cases in spite of their typical clinical findings for diagnosis and their improvement with antifungal therapy. Conclusion. Mycotic keratitis is more frequent in farmers, rural areas, outdoor water supply, insanitary sewage disposal, and patients preceded with organic trauma. Atypical clinical findings were found in some cases and not all cases improved with specific antifungal therapy.

Highlights

Mycotic keratitis is a severe problem in most of the developing countries whereas specific antifungal agents are expensive and commercially unavailable as ready compounds for topical ocular use
Our target was 361 patients with mycotic keratitis representing 0.54% of the total attendants, while those with nonmycotic keratitis accounted for 473 cases representing 0.71% of the total attendants of the clinic during that period
Corneal infections including fungal types are responsible for about 50% of corneal scarring in the developing world which

Summary

Introduction

Mycotic keratitis is a severe problem in most of the developing countries whereas specific antifungal agents are expensive and commercially unavailable as ready compounds for topical ocular use. It is endemic and this is favored by certain ecological factors that already exist in those communities. Other problems like difficulties in its clinical diagnosis, laboratory results, and treatment are incriminated [1]. Mycotic keratitis is an important cause of corneal morbidity, scarring, and blindness caused by fungal invasion through corneal epithelium. Clinical features, and response to treatment, fungal corneal pathogens were divided into filamentous fungi, yeast, and yeast like and dimorphic fungi. The most common filamentous fungi causing keratomycosis are Aspergillus, Fusarium, Curvularia, Alternaria, and Cladosporium, while Candida albicans is the most common form of yeasts [2, 3]

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