Study of etiology, predisposing factors and differential presentations of Mycotic Keratitis in the indigenous population of Manipur (original) (raw)
Related papers
Innovative Publication, 2016
A cross sectional study on clinico microbiological profile of patients with fungal corneal ulcer attending a tertiary care hospital of Shimoga district, Karnataka Abstract Introduction: Corneal ulceration is the most common cause of preventable blindness, second only to cataract in developing countries. Mycotic keratitis accounts of 30-62% of all culture positive infectious keratitis in several Indian studies. Mycotic keratitis is a significant problem in a country like India with a predominantly agrarian population, who encounter ocular trauma with vegetative material. Aim: To study the clinical profile of patients with fungal corneal ulcers in relation to age, sex, risk factors, clinical presentation and laboratory diagnosis in the outpatient department of a tertiary care hospital of Shimoga district. Materials and Methods: A prospective cross sectional study was carried out on all consecutive patients presenting with corneal ulcer attending the outpatient department of a tertiary care hospital of Shimoga district, Karnataka, between August 2013 to July – 2014. Results: Out of the total 90 cases of corneal ulcer, 30 were fungal culture positive. Out of these 30 cases, males [21, 70%] were affected more than females [P < 0.0001]. The age group most commonly affected was 31-40 years [8, 26.67%], patients [24, 80%] residing in rural areas were more affected and most patients were agricultural workers [19, 63.6%]. Corneal trauma [27, 90%] was the most common risk factor [P < 0.0001] and 17 patients [62.96%] had history of trauma with vegetative matter [P < 0.0001]. Incidence of fungal corneal ulcer was highest during the paddy harvesting season. The sensitivity of 10% KOH wet mount preparation was higher [96.96%] than gram – stained smear [87.88%S] [P < 0.0001]. Fungal culture was positive in 30 cases [33.33%]. The most commonly isolated fungal species was Fusarium species [12 cases, 40%] followed by Aspergillus species [8 cases, 26.66%]. Conclusion: Ocular trauma with vegetative material especially in agriculture workers was an important cause of mycotic keratitis. Direct microscopic examination of KOH wet mount preparation is a rapid, sensitive, technique of laboratory diagnosis in mycotic keratitis. It is particularly important for the early initiation of antifungal treatment.
IP International Journal of Ocular Oncology and Oculoplasty, 2020
Introduction: Given the rise in cases of fungal keratitis in recent years, this study was performed to better elucidate the clinical and microbiological profile, risk factors and intervention rates of fungal keratitis at a tertiary referral center in Uttarakhand. Methods: Corneal scraping was collected from 53 consecutive cases of suspected fungal keratitis and was subjected to direct staining and culture. Results: This was a prospective observational study conducted over a period of 1 year after approval from the institutional ethical committee. All the patients which appeared to be fungal or mixed keratitis on clinical examination were included in this study. Out of 53 patients, 37 (69.8%) were males and 16 (30.2%) females with a mean age of 46.04 ± 16.23 years. Maximum patients 18 (33.96%) had the onset of symptoms and signs in the months of July-September. Of all the corneal ulcer which appeared fungal on clinical examination, KOH and culture was positive in 50.9% patients. While 18.9% were mixed type having both KOH and Gram stain positive. Out of 53 patients, 23 had presence of 3 or more typical clinical features of fungal keratits. There was significant association between number of clinical features and KOH and culture positivity. Fusarium and Curvularia species were the most common etiological agents in our region. Conclusions: Predominant outdoor agricultural activity and trauma with vegetative matter was the principal causative factor for corneal injury. Corneal ulcers complicated due to prior treatment by village healers and hence another important concern. The information regarding regional etiology will help empirical management as many eye clinics do not have microbiological facilities.
Etiology of Suppurative Corneal Ulcers in Rural Population of Northern India
Indian Journal of Clinical and Experimental Ophthalmology, 2015
Background: A prospective, interventional, comparative study carried out in rural population of northern India in western UP. Fungal keratitis studies available in literature were also reviewed. Methods: Patients presenting in eye OPD of UPRIMS & R Saifai, Etawah, UP with suspected microbial keratitis were recruited to the study. Corneal ulceration was defined as loss of corneal epithelium with clinical evidence of infection in form of corneal infiltrate with or without hypopyon. Microscopy and culture were performed on all corneal specimens. Results: A total of 105 patients presenting with suppurative keratitis were enrolled in the study from Jan 2014 to April 2015. Fungi were identified as the dominant causative agent of infection (including mixed infections) in 52 patients (49.52%). Bacteria were isolated from 32 cases (30.47%). Mixed infection was present in 9 cases (8.57%). In each case of mixed infection a single bacterial species was associated with a single fungal species. I...
British Journal of Ophthalmology, 2002
Background: A multicentre study was carried out in Ghana and southern India to determine the aetiology of suppurative keratitis in two regions located at similar tropical latitudes. Studies of fungal keratitis from the literature were reviewed. Methods: Patients presenting at rural and urban eye units with suspected microbial keratitis were recruited to the study. Corneal ulceration was defined as loss of corneal epithelium with clinical evidence of infection with or without hypopyon. Microscopy and culture were performed on all corneal specimens obtained. Results: 1090 patients were recruited with suspected microbial keratitis between June 1999 and May 2001. Overall the principal causative micro-organisms in both regions were filamentous fungi (42%): Fusarium species and Aspergillus species were the commonest fungal isolates. Pseudomonas species were most frequently isolated from cases of bacterial keratitis in Ghana but in India the commonest bacterial isolates were streptococci. Conclusion: Infections of the cornea due to filamentous fungi are a frequent cause of corneal damage in developing countries in the tropics and are difficult to treat. Microscopy is an essential tool in the diagnosis of these infections. A knowledge of the "local" aetiology within a region is of value in the management of suppurative keratitis in the event that microscopy cannot be performed.
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.7\_July2021/IJRR-Abstract032.html, 2021
Background-Visual impairment due to corneal ulceration has for long been acknowledged as leading cause of blindness both worldwide and in India only next to Cataract. The aetiology for infective corneal ulcer varies considerably with occupation of patients in different regions of India. Thus, continuing with empirical management without lab diagnosis leads to protracted clinical course. So, understanding the microbial profile of corneal ulcers in agriculture dependent population of Southern Assam helps in improved management of this morbidity. Aims- To 1) Find the prevalence of infected corneal ulcers in untreated patients attending Ophthalmology department of a tertiary care hospital of Southern Assam. 2) Study the pattern of microbial aetiology in the infected corneal ulcer cases. 3) Find the association of infected corneal ulcers with various attributing factors. Method-Corneal scrapings from 86 routine untreated cases of corneal ulceration from Ophthalmology Department were studied prospectively from Dec2017 to Jan2019 and subjected to Gram staining and direct examination with 10%KOH. Culture on SDA and Blood Agar were incubated at 25°C and 37°C respectively and followed up for 3 weeks before declaring sterile. Antimicrobial sensitivity was performed for bacterial isolate and yeast-like species. Slide culture and LPCB tease mount were done for identification of moulds. Result- Out of the 86 cases, 58 were positive in direct microscopy, of which 44 were culture positive. Of the 28 samples negative in direct microscopy, 2 were positive by Culture. Bacterial isolates were found in 5 cases and fungal aetiology in 41 cases. Conclusion- The prevalence of infected corneal ulcer as per standard of Culture positivity is 53.5% (46/86). Mycotic involvement was found in 90% cases. Important fungal isolates identified were Aspergillus species, Penicillium species, Curvularia species, Fusarium species, Sarocladium species. Higher prevalence was significantly associated with harvesting season, agricultural practice and history of trauma while diabetes and steroid intake were not significantly associated with mycotic ulcers.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Corneal ulcer is one of the leading causes of ocular morbidity in developing country. Early diagnosis and targeted therapy is indispensable. Sociodemographic variables along with predisposing factors plays a major role in its development and clinicopathological correlation in diagnosis is very much helpful in diagnosis and subsequent management. The aim of the study is to identify the epidemiological factors and causative organism of the suppurative corneal ulcer. MATERIALS AND METHODS In this observational cross-sectional study, after taking proper history, patients with suppurative corneal ulcer are examined for clinical diagnosis. Applying sterile method of swab collection from the ulcer for standard microbiological examination (staining, culture) swabs are taken for predetermined laboratory investigations. Sociodemographic variables (age, gender, occupation) relevant injury history, microbiological data are tabulated for statistical calculations. RESULTS After application of inclusion and exclusion criteria wiling 81 patients, M:F=55:26 were assessed. Major number of patients (n=61, 75.30%) are middle aged between 33-62 years of age. Occupation played a major role as evidenced by 44.44% (n=36) contribution from agricultural workers (tea garden worker, pineapple farmer, other agricultural worker) followed by household worker (n=13, 16.05%). Positive history of prior corneal injury is common in fungal corneal ulcer (n=22, 51.16%) as well as in bacterial (n=8, 66.66%). Among the prior corneal injury associated fungal ulcer vegetative matter injury in 15 patients (32.60%), while in bacterial variety, it is 5 (10.86%) in number. In laboratory investigations, pure fungal growths are found in 37 patients (45.68%), while pure bacterial are 12 in number (14.81%). A good number (n=8, 9.81%) shows mixed infection. Culture negative ulcers are good in number (n=24, 29.63%) among which 6 (7.47%) are microscopically positive. The sensitivity and specificity of clinical diagnosis of fungal corneal ulcer are 84.61% and 72.41% respectively with a high correlation between clinical and microbiological diagnosis of fungal corneal ulcer (either smear positive or culture positive and a quiet high positive predictive value for clinical diagnosis (84.61%). But, in case of bacterial corneal ulcer, the positive predictive value is 41.37%, while negative predictive value is 84.61% in our study. CONCLUSION Middle-aged agricultural workers are more prone to develop corneal ulcer and fungal corneal ulcers are more prevalent in this region of India than bacterial. History of prior corneal injury is a major risk factor. Fungal corneal ulcers have high correlation between clinical and microbiological diagnosis than bacterial.
Journal of Pure and Applied Microbiology, 2020
Fungal keratitis is one of the causes of severe ocular morbidity and blindness. The prevalence of fungal keratitis has been increased from 7-63%. Culture is mandatory for an Ophthalmologist to guide treatment. The main objective of this study is to identify the etiological agents of Mycotic keratitis in corneal ulcer patients based on the microscopy. A prospective study was conducted with a total of 200 corneal scrapings were collected during the period of January to Setember 2015. Direct smear examination was followed by culture on blood agar and Sabraoud Dextrose agar and incubated at 37°C for 48 hours (BA) and 25°C for seven days (SDA) 48 hrs. The cultures are stored in sterile distilled water. Fungus was isolated from 79 (39.5%) corneal ulcer patients. Out of which 32 (40.5%) were positive with 10% KOH. In the present study, 85% fungal ulcers were diagnosed in female patients and 15% in male. Among 79 fungus, Aspergillus species, Fusarium species, Curvularia species and unidentified dematiaceous fungi were isolated from corneal ulcers. The bacterial agents were identified in 10 patients (5.0%) by direct gram stain as well as culture. Females are the most prevalent for corneal ulcers. Diagnosis of fungal keratitis patients occurs mostly with Fusarium. It suggests that the most of our corneal ulcer patients are infected with the Fusarium. Another risk factor is contact lens for microbial keratitis at the adult age group in Pondicherry. Majority of the fungal keratitis infections have responded to voriconazole for medical management.
PREVALENCE OF FUNGAL KERATITIS IN RURAL POPULATION -AN INDIAN BASED PROSPECTIVE; RETROSPECTIVE STUDY
IASET, 2013
Introduction: Fungal keratitis is a major eye disease leading to blindness in South Asia. Many authors has reported in South India, it was found that 44% of all central corneal ulcers are caused by fungi. This high prevalence of fungal pathogens in South India is significantly greater than that found in similar studies in Nepal (17%), Bangladesh (36%), Ghana (37.6%), and south Florida (35%). In Indian perspectives the incidence of fungal keratitis is being increased during the past decade, due to Intemperate and retrogressive climatic changes. The present study aims to find out the incidence of fungal keratitis in rural population.
Clinical and microbiological spectrum of corneal ulcer in eastern region of Uttar Pradesh
IP innovative publication pvt. ltd, 2019
Aim: To find clinical microbiological spectrum and predisposing factors of corneal ulcer in eastern Uttar Pradesh. Materials and Methods: This was a hospital based prospective study conducted in Regional Institute of Ophthalmology, IMS, BHU, Varanasi, over a period of three years from May 2015 to April 2018.Suspected microbial keratitis were stained with fluorescent paper strip and examined under cobalt blue light. Scraping of the edge and bases were directly inoculated on Sabouraud’s Dextrose Agar and Blood Agar. Plates were examined daily in 1st week then every 3rd day for next 3 weeks. Results: Maximum cases were seen in the age group of 25-50 years (63.79%), with male preponderance (60.30%). Trauma to the affected eye was major predisposing factor for microbial keratitis (74.10%). The major etiological agent in our study was fungal corneal ulcers followed by bacterial ulcer. Aspergillus spp. (53.84%) was most common filamentous fungi followed by Fusarium spp. (23.07%). Among bacteria most common species was Staphylococcus aureus 57.89% followed by Streptococcus pneumoniae and Pseudomonas aeruginosa present in 21.05% and 15.78% respectively. Conclusions: The major aetiological agent in our study was fungal corneal ulcers followed by bacteria ulcer. Filamentous fungi were most common cause of fungal corneal ulcer with Hyaline fungi (80.76%) and Phaeoid fungi (11.53%).