European Journal of Molecular & Clinical Medicine

Abstract

Background: Corneal blindness is a major public health problem globally and infectious keratitis tend to be a predominant cause. Fungal corneal ulcer found to be very common in India due to the tropical climate and a large agrarian population that is at risk. The aim of the study is to identify the risk factors, clinical characteristics, causative fungal agent and treatment outcome of fungal keratitis in South India.
Methods:  A prospective study was conducted in all patients with clinically suspected infectious keratitis at Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, Telangana from January 2019 to December 2021 to determine the causative fungal agents and to identify the risk factors of fungal keratitis. Direct microscopy of corneal scrapings was done by Gram’s staining and 10% KOH preparation Fungal culture was done using SDA medium and incubated at 25°C and 37°C. Fungal culture reports were declared negative at the end of 14 days.
Results: Of the 358 samples processed, 224 were identified as infectious keratitis, bacterial organisms were identified in 98 (27.37%) cases and fungal isolates were identified in 126 (35.19%) cases, of which17(13.49%) cases were mixed with bacteria and no organism in 134 (37.43%). This study reports mycotic keratitis was predominantly due to the filamentous fungi, Aspergillus spp. and   Fusarium spp. and trauma was to be most common predisposing risk factor observed.
Conclusion: Fungal keratitis continues to be an important cause of ocular morbidity, a strong clinical suspicion of fungal keratitis is crucial in early diagnosis. Direct microscopic detection of fungal structures in corneal scrapings permits a rapid presumptive diagnostic tool in timely and specific management. By choosing appropriate antifungal agents we can combat the disease efficiently, and prevent blindness.