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Clinico-Epidemiological Study of Mycotic Keratitis at a Tertiary Care Hospital

Jithendra Kandati, Professor, Department of Microbiology, Narayana Medical College, Chinthareddypalem, Nellore Andhra Pradesh, India524003 , Sreelakshmi Kothapalli1 , Skandha Harshitha Sarvepalli2 , Jithendra Kandati3 , Mohanrao Nandam4

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Ophthalmology and Allied Sciences 3(2):p 133-139, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/oas.2454.7816.3217.17

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Abstract

Aims: To study the various clinical presentations of mycotic keratitis based upon the type of fungi and predisposing factor. To study, the epidemiological features of confirmed culture proven cases of mycotic keratitis and to identify the etiological agents. Settings & Design: A prospective hospital based cross sectional study at a tertiary care hospital for a period of 3 years from October 2013 to September 2016. Material & Methods: 800 culture confirmed cases of mycotic keratitis were enrolled in the study and followed regularly. The demographic, epidemiological characters and clinical examination findings by slit lamp examination were noted. Corneal scrapings and swabs were sent to laboratory for cultivation and identification of fungi. Statistical Analysis: The collected data was entered in Microsoft excel spread sheet, verified and entered in MEDCALC software and analyzed for statistical significance. Results: Males were more common in the study (66.25%), 2130 years age group were more common(29.4%) and the incidence of mycotic keratitis was 38.28%. 78% were of rural background and 65.5% of cases were agricultural workers/farmers. Trauma was the common predisposing factor (78.75%) and traumatic agent was vegetative matter like husk, straw etc. Anterior chamber reaction was the commonest finding in slit lamp examination (91%).Fusarium sp was the common fungi (34.2%) followed by Aspergillus sp (32.5%). Candida sp accounted for 18.2% in the study. Pseudomonas aeruginosa was the commonest bacterial pathogen isolated (62.6%). Conclusion: our study highlights the demographic particulars of mycotic keratitis and epidemiological characters and clinical presentation in our geographic region. Early diagnosis of the condition is imperative for management either surgical or medical management. KOH wet mount is a simple microscopic diagnostic choice with more specificity which can be used in diagnosis of fungal keratitis.

Keywords: Mycotic Keratitis; Fusarium; Aspergillus SP; Pseudomonas Aeruginosa; KOH Wet Mount. 

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DOI: http://dx.doi.org/10.21088/oas.2454.7816.3217.17

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