FUNGAL PROFILE OF INFECTIOUS KERATITIS IN A TERTIARY CARE HOSPITAL - OUR EXPERIENCE

Abstract

AbstractInfectious keratitis world wide are a leading cause of ocular morbidity and blindness. A large number of filamentous fungi, Yeasts and Zygomycetes have been incriminated as the causative agent of mycotic keratitis. Early diagnosis and treatment is important in preventing complications like corneal perforation, scleral spread and endopthalmitis. The present study was conducted to elucidate the epidemiological features of mycotic keratitis and study the fungal profile of mycotic keratitis of patients attending our hospital, which is situated on the coastal area of Karnataka.A total of 127 patients with infectious keratitis were investigated between January 2009 to June 2010. Corneal scraping was obtained from 127 patients under aseptic precaution. The scraping was subjected to 10% KOH wet mount, Gram's staining and culture. Of the total 127 patients suspected of having infectious keratitis, 44 (34.65%) were found to be positive for fungal aetiology. Of these, 40(90.90%) cases were positive on direct microscopy for fungal elements and 26(59.09%) cases showed growth on culture after incubation for 2-8 days. In 14 (31.81%) cases, the culture was found to be sterile despite positive direct microscopic findings, but the results were consistent with clinical findings. Positive culture was obtained in 4(09.09%) cases where direct microscopy was found to be negative. The commonest fungi isolated were Aspergillus species (61.5%)Mycotic keratitis continues to be an important cause of ocular morbidity, predominantly among rural population. Prompt diagnosis and early institution of antifungal therapy may limit the ocular morbidity and the sequelae of infectious keratitis. As the manifestation of mycotic keratitis is often confusing, a high degree of suspicion with sound knowledge of predisposing factors and microbiological confirmation is very essential to initiate appropriate therapy.