Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study

Abstract

Objective: Corneal blindness is a major public health problem worldwide and mycotic keratitis is one of the predominant causes. Infection is difficult to treat and can lead to severe visual impairment or blindness. It is worldwide in distribution but is more common in tropics and subtropical region. Trauma is the major predisposing factor, followed by ocular or systemic defects, prior application of corticosteroids, and prolonged use of antibiotic eye drops. The purpose of this study was to document the clinical and epidemiological features and laboratory diagnosis of fungal corneal ulcer.

Methods: Patients who presented with clinically suspected corneal ulcer to ophthalmology department registered for the study. Data were collected through history and slit lamp examination. Corneal scrapping was performed. A portion of each scrapping was examined by direct microscopy. Another portion was inoculated directly on to solid culture media. Results: This study included 40 subjects with corneal ulcer based on clinical suspicion, of whom 14 cases were diagnosed with mycotic keratitis in the laboratory. Among these 14 cases, culture showed fungal growth only in 12 cases where the remaining cases were positive only by Potassium hydroxide (KOH) preparation. Males were more commonly affected and were mostly in the age group of 21 to 50 years. Aspergillus species and Fusarium species were the major isolates.

Conclusion: Rapid diagnosis and early institution of anti-fungal therapy is necessary to prevent ocular morbidity and blindness. The direct microscopy method by KOH is rapid, inexpensive and reliable method and culture helps in definite diagnosis and identification. J Microbiol Infect Dis 2015;5(3): 99-102

Key words: Mycotic keratitis, potassium hydroxide, Aspergillus species, Fusarium species.

Keywords

• Mycotic keratitis, potassium hydroxide, Aspergillus species, Fusarium species

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Öz

Amaç: Korneaya bağlı körlük bütün dünyada önemli bir halk sağlığı problemidir ve mikotik keratit önde gelen sebeplerinden biridir. Enfeksiyonun tedavi edilmesi zordur ve görme bozukluğuna ve körlüğe yol açabilir. Bu bütün dünyada görülebilmektedir ancak tropik ve subtropik bölgelerde yaygındır. Travma önemli kolaylaştırıcı faktördür ve ardından oküler ve sistemik yetmezlikler, önce kortikosteroit uygulamaları ve antibiyotikli göz damlalarının uzun süre kullanımı gelir. Bu çalışmanın amacı fungal korneal ülserin klinik ve epidemiyolojik özelliklerini ve laboratuvar tanısını dökümante etmektir.Yöntemler: Göz kliniğine klinik olarak korneal ülser şüphesi ile başvuran hastalar bu çalışmaya dahil edildi. Veriler hikayelerinden ve fizik muayene bulgularından toplandı. Korneal temizlik/ayıklama yapıldı. Çıkarılan her parça mikroskopta incelendi. Diğer bir parka doğrudan katı besiyerinde kültüre edildi. Bulgular: Çalışmaya klinik olarak kornea ülseri olan 40 olgu dahil edildi, bu olguların 14’ü laboratuvarda mikotik keratit olarak teşhis edildi. Bu 14 olgunun 12’sinde kültürde mantar üremesi oldu, geri kalan olgularda yalnızca potasyum hidroksit (KOH) preparatları pozitif idi. En çok etkilenenler 21-50 yaş arası erkekler idi. Aspergillus türleri ve Fusarium türleri en sık izole edilen türler idi. Sonuç: Hızlı tanı ve antifungal tedavinin erken başlanması gözün hastalıktan ve körlükten kurtulabilmesi için önemlidir. KOH ile direkt mikroskopik metot hızlı, ucuz ve güvenilirdir ve kültür tanı konulmasına ve kesinleştirilmesine yardım eder

Anahtar Kelimeler

• Mikotik keratit, potasyum hidroksit, Aspergillus türleri, Fusarium türleri

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