AIM: To determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital. ·METHODS: A retrospective analysis of fungal corneal ul...AIM: To determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital. ·METHODS: A retrospective analysis of fungal corneal ulcers was done from 2003-2012. Patients’ clinical data were noted from the file records. Correlation of histopathological diagnosis was done with the report on fungal culture. · RESULTS: Mycotic keratitis was established in 44 cases by a positive fungal culture. Direct microscopic examination of potassium hydroxide(KOH) mounts revealed fungal elements in 39 cases while 40 cases showed fungus on Gram stained smears. Males(54.55%) were more commonly affected than the females(45.45%). The age ranged from 18 to 82 years. Most common age group to be involved was 41-60 years. Predisposing risk factors were seen in 34(77.27%) cases. Most common findings on clinical examination were anterior chamber reaction and conjunctival injection seen in all the cases. Other common findings were stromal infiltration and hypopyon seen in 20(45.45%) and 18(40.91%) cases respectively. On histopathological examination the fungus was typed,as aspergillus in 34 cases while no definite typing was possible in 10 cases. The predominant isolate was aspergillus flavus(59.09%) followed by fusarium(15.91%). Mixed fungal and bacterial infection was seen in 3(6.82%) cases. ·CONCLUSION: Although culture is the gold standard for definitive diagnosis of fungal keratitis,direct microscopic examination of corneal scrapings or histomorphological evaluation of biopsies allow a rapidpreliminary diagnosis. Early administration of antifungal treatment helps in preventing dreadful complications.展开更多
文摘AIM: To determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital. ·METHODS: A retrospective analysis of fungal corneal ulcers was done from 2003-2012. Patients’ clinical data were noted from the file records. Correlation of histopathological diagnosis was done with the report on fungal culture. · RESULTS: Mycotic keratitis was established in 44 cases by a positive fungal culture. Direct microscopic examination of potassium hydroxide(KOH) mounts revealed fungal elements in 39 cases while 40 cases showed fungus on Gram stained smears. Males(54.55%) were more commonly affected than the females(45.45%). The age ranged from 18 to 82 years. Most common age group to be involved was 41-60 years. Predisposing risk factors were seen in 34(77.27%) cases. Most common findings on clinical examination were anterior chamber reaction and conjunctival injection seen in all the cases. Other common findings were stromal infiltration and hypopyon seen in 20(45.45%) and 18(40.91%) cases respectively. On histopathological examination the fungus was typed,as aspergillus in 34 cases while no definite typing was possible in 10 cases. The predominant isolate was aspergillus flavus(59.09%) followed by fusarium(15.91%). Mixed fungal and bacterial infection was seen in 3(6.82%) cases. ·CONCLUSION: Although culture is the gold standard for definitive diagnosis of fungal keratitis,direct microscopic examination of corneal scrapings or histomorphological evaluation of biopsies allow a rapidpreliminary diagnosis. Early administration of antifungal treatment helps in preventing dreadful complications.
