Spectrum of fungal keratitis:clinicopathologic study of 44 cases |
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Authors: | Rajpal Singh Puni Reetu Kundu Jagdish Chander Sudesh Kumar Ary Uma Handa Harsh Mohan |
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Affiliation: | Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India;Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India;Department of Microbiology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India;Department of Ophthalmology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India;Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India;Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh 160030, India |
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Abstract: | AIMTo determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital.METHODSA 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.RESULTSMycotic 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.CONCLUSIONAlthough culture is the gold standard for definitive diagnosis of fungal keratitis, direct microscopic examination of corneal scrapings or histomorphological evaluation of biopsies allow a rapid preliminary diagnosis. Early administration of antifungal treatment helps in preventing dreadful complications. |
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Keywords: | mycotic keratitis fungal culture infection cornea |
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