ARTICLES
Year : 1985 | Volume
: 33 | Issue : 4 | Page : 229--231
Study of mycotic keratitis
VC Poria, VR Bharad, DS Dongre, MV Kulkarni
Department of Ophthalmology and Microbiology, M.P. Shah Medical College, Jamnagar, India
Correspondence Address:
V C Poria
Department of Ophthalmology and Microbiology, M. P. Shah Medical College, Jamnagar
India
How to cite this article:
Poria V C, Bharad V R, Dongre D S, Kulkarni M V. Study of mycotic keratitis.Indian J Ophthalmol 1985;33:229-231
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Poria V C, Bharad V R, Dongre D S, Kulkarni M V. Study of mycotic keratitis. Indian J Ophthalmol [serial online] 1985 [cited 2023 Apr 1 ];33:229-231
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Full Text
Need for rapid diagnosis and identification of causative agent, is there in cases of fungal keratitis. The aim of this presentation is to determine the presence of fungus in clinically suspected cases of mycotic keratitis.
MATERIAL AND METHODS
One hundred cases, clinically suspected as mycotic corneal ulcer were taken for study.
After clinical examination, scraping was done from the floor of the corneal ulcer with a blunt side of knife. One portion of the material was examined by wet preparation with 10% KOH for mycelial structure, spores or budding cells. Some portions were inoculated in Sabouraud's glucose agar slants and incubated at room temperature and at 37°C. Culture tubes were examined daily for the growth and tubes showing no growth for 3 weeks were regarded as sterile. Identification of fungus was done according to method described by Emmons et al[1] and Conant et al[2].
OBSERVATIONS
Out of 100 cases of clinical fungal corneal ulcer, fungal growth was seen in 37 patients. Various species of the fungus isolated are summarised in [Table 1]. Fusarium species topped in the list, out of'37 isolates 12 (32.3%) were Fusarium, while second highest is Aspergillus, 10 (27.1%) isolates.
Various aetiological factors related to mycotic keratitis are as follows:
Age incidence : The age incidence of 37 positive cases were studied. All age groups are affected, but elderly patients are found to be more affected, highest incidence is seen in the age group of 41 to 50 years (32.3%).Sex : Mycotic keratitis was found a little more common in the male 57% than in female 43%.Occupation : The highest incidence of mycotic keratitis found in agricultural labourers-20 cases (54%), whereas next affected are housewives 8 cases (21.6%), [Table 2].Seasonal variation : It is seen from [Table 3] that mycotic infection is more common during the harvesting season. There were 41 cases reported during September- October.History of injury : Out of 37 cases in 30 cases (81%) there was a history of injury to the eye by trauma, with vegetable matter like leaves of tree, grass, wooden stick of plant and soil, throe, metal like iron.Time interval between the injury and reporting to the hospital : 55.5% of cases sought medical aid after an interval of 1-2 weeks, this is because of the slow; indolent, torpid behaviour of the lesion. Some of the patients, urban or rural area were getting first aid treatment by themselves. During this time the fungal ulcer becomes more prominent.Steroid-antibiotic and herbal medication : 12 patients out of 37 (32.3%) were using steroid and antibiotics, while three cases gave history of the eye being treated with herbal drops and indigenous drug.
DISCUSSION
The value of direct microscopy is well known in rapid diagnosis of fungal diseases. Out of 37 culture positive cases 23 cases were positive by 10% KOH (62.1%) and culture both, while 14 cases were positive by culture and negative by 10% KOH preparation.
The most common type of fungus responsible in present study was Fusarium, 12 cases out of 37 (32.3%). Higher incidence is reported by Anderson and Chick[3], Jones et a1[4] while lower incidence is reported by Puttanna[5] and Siva Reddy[6]. Second highest percentage of Fungus type was Aspergillus species (27.1%) in the present study. These findings are in accordance with those of Sandhu et al' and Kulshreshtha et al[8].
Out of 37% cases of fungal keratitis there were 7 cases due to mycelia sterila, 3 cases due to Candida species, one strain each of Curvularia, Cladosporium, Palularia, Streptomyces and Trichothesium, each constituted 1 case in the present study similar study sought by some workers[9],[10].
Out of 37 cases, 12 were (32.2 %) positive who had used corticosteroids and antibiotics. Role of prolonged use of antibiotic and corticosteroid has been greatly emphasized. Out of 37 (54%) were agricultural labourers. These findings are similar to the findings of other workers[5],[6],[11]. Mycotic keratitis was found a little more commonly in the male 57% than in female 43%.
Higher incidences of mycotic keratitis (41 patients) were reported during the months of September, October. During this time, in our area, harvesting season is going on. Various factors like humidity, temperature and rush of field work may account for this seasonal variation.
SUMMARY
Of 100 clinically suspected mycohe ulcer cases of 37 (37%) showed growth of fungus by culture. Fusarium species was the commonest species isolated with the frequency of 32.3%. Occu-pational observation shows that agricultural labourers (54%) and housewives (21.6%) were commonly affected. History of trauma to the eye by vegetable matter, and application of antibiotic and cortisone therapy are the contributing factors for the occurrence of mycotic keratitis.
References
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| 2 | Conant, N.F., Smith, D.T., Baker R.D., Callaway J.L., 1971, Manual of Clinical Mycology, 3rd Ed., op. 699 -724, Saunders Company, Philadelphia. |
| 3 | Anderson, B., Roberts. Gonalez C. and Chiek E 1959, Arch Ophthalmol 62: 169. |
| 4 | Jones, D.B., Forster R.R. and Rebell., 1972, Arch. Ophthalmol, 88: 147. |
| 5 | Puttanna, S.T. 1969, J. All India Ophthalmol. Soc. 17 :171. |
| 6 | Siva Reddy, P., Satyendra O.M., Satpathy and Ranga Reddy P., 1972, lad. J Ophthalmol 20 : 101. |
| 7 | Sandhu, D.K., Dudani A. and Singh S, 1980, Tropical disease bulletin, 77:567. |
| 8 | Kulshtreshtha, O.P., Bhargava, S.W. and Dube, S.K, 1971, Ind. J. Opththalmol 21 : 51. |
| 9 | New Mark E., Kaufman H., Polak F., and Ellison A, 1971, South Med. J. 64 :935. |
| 10 | Nityananda, K. Sivasubramaniam, P, and Ajello, 1964, Arch. Ophthalmol. 71 :456. |
| 11 | Balkrishnan, E, 1961, Brit. J. Ophthalmol. 45: 828. |
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