A survey of fungi from eye patients in Lucknow

OP Srivasatava; RL Koul; SP Gupta

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Year : 1976 | Volume : 24 | Issue : 1 | Page : 19-21

A survey of fungi from eye patients in Lucknow

OP Srivasatava, RL Koul, SP Gupta
K.G.Medical College, Lucknow, India

Correspondence Address:
O P Srivasatava
Central Drug Research Institute, Lucknow
India

Source of Support: None, Conflict of Interest: None

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PMID: 1031379

How to cite this article:
Srivasatava O P, Koul R L, Gupta S P. A survey of fungi from eye patients in Lucknow . Indian J Ophthalmol 1976;24:19-21

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Srivasatava O P, Koul R L, Gupta S P. A survey of fungi from eye patients in Lucknow . Indian J Ophthalmol [serial online] 1976 [cited 2023 Dec 10];24:19-21. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1976/24/1/19/31103

Table 2

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Table 1

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In tropical countries, like India, conjunctival and corneal conditions present one of the most important ophthalmic problems. The climatic conditions (humidity and temperature) are favourable for the growth and proliferation of fungi. During the last one and a half decade there has been an increase in the incidence of fungal ocular lesions and occurrence of fungi, considered to be saprophytic for human beings, have been reported in diseased conditions of the eye. Nithyananda, Sirasubramaniam and Ajello11] reported Curvularia lyrata as the cause of mycotic keratitis. According to Newmark and Polackt0 species of Fusarium, Aspergillus and Cephalosporium are involved in cases of keratomycosis. Recently Cylindrocarpon tonkinensis, Botryodiplodia theobromae and Phialophora gougerotii have been reported to cause mycotic keratitis.[8]

The present communication reports the fungal flora of the normal conjunctiva and of the clinically diagnosed cases of corneal ulcer, conjunctivitis and dacryocystitis.

Materials and Methods

For normal cases patients who had no conjunctivitis or sac infection, had no history of any discharge of watering from the eyes and were not using any antibiotic or corticoid ointment, were selected from the Refraction Unit of Gandhi Memorial and Associated Hospitals, Lucknow. Swabs with sterilised swab sticks were taken from the lower fornix of the conjunctiva and introduced aseptically in Sabouraud's agar slants containing 0.05 mg. Chloromycetin/ml. The slants were incubated at 28±1^oC. for 3 weeks and observed periodically. Ten cases that proved negative for fungi in culture were put on local hydrocortisone treatment for 3 weeks. Swabs were taken post treatment, inoculated and incubated in the same manner. Scrapings from ulcer margins were used for inoculation in cases of corneal ulcer. In conjunctivitis cases, swabs were taken from the discharge and in case of sac infection (chronic dacryocystitis) from the regurgitated fluid.

Further study of the different fungi isolated was done in Sabouraud's15 and Czapek Dox agar media[13] . Species of Aspergillus were identified following Raper and Fennell13 and the other fungi were identified with the help of Manual of Clinical Mycology[4]

Discussion

Fungi encountered in normal eye patients and in patients with corneal ulcer, acute conjunctivitis and chronic dacryocystitis are presented in [Table - 1].

The highest percentage of cases positive for fungi were from corneal ulcer patients. Species of Aspergillus were isolated from 21 out of a total of 33 patients positive for fungi and the maximum number of isolates were of A. fumigatus followed by those of A. niger. Raper and Fennel113 have recorded A. fumigatus pathogenic for human eye. A. terreus, A. nidulans, A. flavus and A. candidus were not found in normal patients while A. ustus and A. wentii were found only in normal patients. Fungal toxins have been reported from A. flavus, A. niger, A. glaucus and A. wentii but have been confirmed only from A. flavus[3]. Among the other fungi encountered Hormodendrum sp. was the most common followed by Scopulariopsis sp. and Penicillium sp. The latter, Cladosporium sp. and phycomycetous fungus were not found in normal patients and Candida ablicans and Mycelia sterilia were encountered only in normal cases in the present investigation. However, C. albicans is a well known human pathogen. Prabhakar, Chitkara and Prabhakar[12] reported the isolation of Hormodendrum sp. from a single normal case in Amritsar. We have isolated this fungus from one normal case and three diseased eyes.

The fungi encountered in this survey along with several other genera and species from normal and diseased eyes have been reported by Fazakas[5],[6] from Central Europe, Mitsui and Hanabusa[9]from Japan; Hammeke and Ellis[7] from Arkansas; Alinley and Smith from United Kingdom; Williamson and Gordon[16] from England; Agarwal and Khosla' Sinha & Dasla, Prabhakar, Chitkara[12] & Prabhakarl` from India.

On the basis of our present work Aspergillus ustus, A. wemii and A. candidus are new additions to the fungi found associated with normal and diseased eyes and reported in literature so far.

Five cases, out of 10 normal cases (negative for fungi), became positive for fungi after 3 weeks topical hydrocortisone treatment. The fungi isolated were, Aspergillus sp. in two cases and A. terreus, phycomycetous fungus and Gcotrichum sp. each in one case. This finding is in agreement with the work of earlier investigators.[1],[2],[9]

Data regarding sex, rural/urban, age and monthly income of patients are summarised in [Table - 2]. More positive cultures were obtained from female patients than male patients and the same was true for patients drawn from urban area in comparison to rural area. Percentage of positive cultures was highest in urban corneal ulcer patients. Number of patients in the monthly income group above Rs. 300/and in the age group above 60 years was very few in this study and none were positive for fungi in the latter case.

Summary

Aspergillus fumigatus, A. niger, A. glaucus, A. terreus, A. ustus, A. wentii, A. nidulans, A. flavus, A. candidus, Hormodendrum sp., Scopulariopsis sp., Penicillium sp., Candida albicans, mycelia sterilia, Cladosporitnn sp. and phycomycetous fungus have been encountered in a survey of fungi from eye patients in Lucknow. A. ustus, A. wentii and A. candidus are new additions to the fungi reported from eye patients so far. More positive cultures were obtained from female patients and from patients drawn from urban area.

Acknowledgements

The authors thank Dr. V.C. Vohra for his interest in this work and Sri Binzal Chandra for his valuable technical assistance during the course of this investigation.

References

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