Spectrum of mycotic corneal ulcers in a tertiary care hospital in Eastern India

Abstract

Background: Fungal keratitis is a major ophthalmic problem. Many microorganisms can cause infectious corneal ulcer. Among them are bacteria, fungi, viruses, protozoa, and chlamydia. Mycotic keratitis is an infection caused by fungus that leads to inflammation and ulceration. Materials and Methods: The cases for the present study were selected from the patients admitted in the eye ward of M.G.M. Medical College and L.S.K. Hospital, Kishanganj (Bihar) during the period from June 2011 to November 2013. Out of all corneal ulcer cases admitted during this period 100 cases clinically suspected to be due to fungal infection were selected for the study. Conjunctival swab cultures were carried out from eyes of 10 clinically normal cases to study the fungal flora of conjunctival sac. Results: During the course of study, out of 100 cases fungi could be isolated from 29 cases only. This showed that only 29% of the suspected cases suffered from mycotic keratitis. The majority of cases were in between 30 and 50 years. The incidence of keratomycosis was found to be the highest during the period from December to February (58.60%) which is a harvesting season of this region. Circumcorneal congestion was present in all the proved mycotic keratitis cases. Culture positive cases showed growth of fungus within 2 weeks of incubation in Sabouraud’s glucose agar media at room temperature. Incidence of Aspergillus keratitis was the highest (65.50%), Candida (13.79%), Penicillium (13.79%), and Fusarium 96.89%). Conclusion: The fungal etiology in the causation of corneal ulcer varies in relation to age, sex and occupation of the population and climatic condition of the region. Keratomycosis occurs more frequently during the harvesting season of the year. Aspergillus is the commonest variety among the species of fungus from the mycotic corneal ulcer.