Table 5 Comparison of microbiological and clinical data on fungal keratitis from studies from various parts of India
From: Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern india
Parameters | Bharathi et al (South)[2] | Despande et al(West) [6] | Saha et al (North East)[7] | Chander & Sharma (North)[4] | Present study (East) |
|---|---|---|---|---|---|
General | |||||
Type of study | Retrospective | Prospective | Retrospective | Prospective | Retrospective |
Period of study | Sep1999-Aug2002 | 1988-1996 | 2008 | Jan1987-Dec1992 | July2006-Dec2009 |
Duration | 3 years | 9 years | 1 year | 6 years | 3.5 years |
No. of patients with microbial keratitis | 3183 | 1010 | 289 | 730 | 997 |
Microbiology | |||||
Culture positive for fungus | 1171(36.7%) | 367(36.3%) | 74(25.6%) | 53(7.3%) | 215(21.5%) |
Nature of sample from which fungus isolated | |||||
Corneal scraping | 1171/1171(100%) | 367/367(100%) | 41/74(55.4%) | NM | 172/215(80.0%) |
Corneal tissue | NM | NM | 16/74(21.6%) | NM | 7/215(3.2%) |
Corneal scraping and tissue | NM | NM | NM | NM | 36/215(16.7%) |
Analysis of wet mount and different staining methods | |||||
KOH/CFW positive | 1181/1181 (100%) | 367(36.3%) | 110(38.06%) | NM | 238/251(94.8%) |
Gram positive | 1039/1181 (87.9%) | 347(34.4%) | NM | NM | 199/252(78.9%) |
Giemsa Positive | NM | NM | NM | NM | 83/105(79.0%) |
Smear positive Culture negative | 11/1181(0.9%) | 0 | 36/289(12.4%) | NM | 49/257(19.0%) |
Fungal culture Positive | 1095/1181(92.7)% | 36.3% | 74/110(67.2%) | 7.3% | 215/264(81.4%) |
Most common Fungal isolate | Fusarium spp. (43%) | Aspergillus spp. (67.8%) | Aspergillus spp. (55%) | Aspergillus spp. (40%) | Aspergillus spp. (28%) |
2nd common isolate | Aspergillus spp. (26%) | Candida spp. (9.8%) | Candida spp. (19%) | Fusarium spp. (16.4%) | Fusarium spp. (23%) |
Concomitant infection | |||||
Mixed with bacteria | 76/1181(6.4%) | 40/367(10.8%) | NM | NM | 17% |
Most common Bacterial isolate | NM | Pseudomonas aeruginosa (66%) | NM | NM | Staphylococcus spp. (31%) |
Clinical aspect | |||||
Age Range | 31-40(24%) | 31-40 | 50-60 | 51-60 | 50-60 (63%) |
Gender | Male (65%) | Male | Male | Male | Male (70%) |
Residence Rural | 80.3% | NM | NM | NM | 79.5% |
Urban | 20% | Â | Â | Â | 21% |
Most common predisposing factor | Trauma (92%) | Trauma (55%) | Trauma (48%) | NM | Trauma (40%) |
Occupation | Farmer (65%) | NM | NM | NM | Farmer (28%) |
Clinical Diagnosis | |||||
Fungal keratitis | 94.1% | 100% | NM | NM | 71% |
Bacterial keratitis | NM | NM | NM | NM | 9% |
Viral keratitis | NM | NM | NM | NM | 1.5% |
Acanthoemba keratitis | NM | NM | NM | NM | 0.4% |
Treatment given | |||||
Topical natamycin or voriconazole | NM | NM | 100% | NM | 94.3% |
Systemic ketoconazole | NM | NM | 100% | NM | 60% |
Therapeutic PK | NM | NM | 60% | NM | 21% |
Evisceration | NM | NM | NM | NM | 3.4% |
Treatment outcome | |||||
Scar | NM | NM | 40% | NM | 35% |
Healing time < 3 weeks | NM | NM | NM | NM | 32% |
Duration of symptoms Early onset < 10 days | NM | NM | NM | NM | 92(34.8%) |
Late onset > 10 days | NM | NM | NM | NM | 172(65.2) |