Table 5.
Comparison of microbiological and clinical data on fungal keratitis from studies from various parts of 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% | 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) |