Incidence of fungal keratitis in patients with corneal ulcer in tertiary care centre of western Rajasthan
Dr. Mohd. Salim Jajodia
Aims & Objective: The purpose of this study was to determine the predominant causative microorganism, and to identify the predisposing factor of fungal keratitis. Materials & Method: The study was conducted in department of microbiology in collaboration with ophthalmology department, SP medical college, Bikaner, India, between July 2017 to December 2017. Corneal scraping were taken with full aseptic precautions in total 42 clinically suspected cases of corneal ulcer. The specimens collected were then smeared for 10% KOH for fungal keratitis. Two corneal swab were taken and directly inoculated on Sabouraud’s Dextrose Agar (SDA) with Actidione and without Antibiotics in Two Tube set, one tube set incubated at 200C and other at 37ºC. All KOH mount were subjected for culture on SDA and followed by L.P.C.B mount. Results: A total 42 clinically suspected cases of corneal ulcer were studied for KOH Mount and fungal culture to isolates aetiological agents. 22 (52.38%) sample were positive in KOH mount And fungus was grown in 14 KOH positive samples and in 3 KOH negative samples. Aspergillus spp. were isolated in 8 cases, Fusarium spp. in 6 cases and Alternaria spp. in 3 cases out of 17 positive cases. Most of the positive cases were from age >50 years. Male were more commonly affected than female (13 v/s 4). Most of the patients were farmers and labours. A total of 42% of patients recalled the history of trauma with plant debris and straws. A total of 22% patients received topical antibiotics or corticosteroids. Conclusion: Fungal keratitis is frequent causes of blindness it requires rapid detection and identification of fungal agents. The direct microscopy method (KOH MOUNT) is a single most important screening method for rapid diagnosis of fungal corneal ulcer.