, Volume 65, Issue 1–3, pp 155–166 | Cite as

Role of opportunistic fungi in ocular infections in Nigeria

  • H. C. Gugnani
  • S. Gupta
  • R. S. Talwar
Opportunistic Medical Pathogens


The importance of opportunistic fungal pathogens in causing ocular infections is emphasized. A study was conducted over a period of 4 years (1974–1977) to investigate the role of opportunistic fungi in causing mycotic keratitis and to elucidate certain aspects of epidemiology of this disease in Nigeria. Fifty-nine cases of corneal ulcers of suspected mycotic etiology were investigated. Fungal etiology was confirmed in 42 of these cases. The predominant etiological agent was Fusarium solani in 14 cases (33.33%) followed by Penicillium citrinum in 8 cases (19.04%) and Aspergillus fumigatus in 5 cases (11.90%). The yeasts were responsible for only 3 cases (7.14%) i.e. one each caused by Candida albicans, C. parapsilosis and C. guilliermondii. Among the remaining 12 cases, one was caused by F. moniliforme, 3 by A. flavus, 2 each by A. niger, Penicillium expansum and Penicillium sp., and one each by Cladosporium cladosporioides and Cladosporium sp. The clinical features of the cases are briefly described.

The incidence of mycotic keratitis in relation to sex, age, occupation, trauma and other factors has been analysed. Corneal trauma appeared to be an important predisposing factor as 27 (67.28%) of the patients gave a history of injuries to the eye. Notably, a large number of patients were farmers and trauma was most often from palm tree leaf, thorn, kernel or other plant objects. Topical application of corticosteroids or broad spectrum antibiotics did not seem to play an important role in the etiology of keratomycosis. Cases were recorded throughout the year although the number of cases was higher in the months of March –May, and November–December than that during the rest of the year.

The isolates of the causative agents were studied in detail for their morphological and cultural characters. The isolates of F. solani grew well at 37°C and survived at 40°C for more than 3 weeks. In vitro drug sensitivity tests indicated good antifungal activity of pimaricin and econazole for F. solani, clotrimazole and econazole for Aspergillus fumigatus, A. flavus and Penicillium citrinum, and 5-fluorocytosine for Candida spp.

Investigations on the incidence of fungi in normal healthy eyes of 450 persons comprising 204 adults and 246 children yielded 204 isolates belonging to 21 genera of fungi. Cladosporium was most frequent (12.88%) followed by Penicillium (10.22%) and Aspergillus (6.66%). Another important fungus was Fusarium represented by 10 isolates, viz. 4 of F. solani, 2 of F. moniliforme, 1 of F. exysporum, and 3 of Fusarium sp. The yeasts were represented by two isolates each of Candida tropicalis, C. pseudotropicalis, C. krusei, Trichosporon sp and Cryptococcus albidus, and one of Candida guilliermondii. Successive culturing of fungi from normal eyes in a small group indicated that fungi occur in the outer eye generally as transients.

The epidemiology of mycotic keratitis has been discussed in relation to the present findings and in comparison with observations of other investigators.


Fusarium Penicillium Aspergillus Fumigatus Cladosporium Clotrimazole 
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  1. 1.
    Ainley, R. & B. Smith. 1965. Fungal flora of the conjunctival sac in healthy and diseased eyes. Brit. J. Ophthal. 49: 505–515.Google Scholar
  2. 2.
    Ainsworth, G.C., F.K. Sparrow & A.S. Sussman (eds.). 1973. The Fungi, an Advanced Treatise, vol. 4A. Academic Press Inc., New York.Google Scholar
  3. 3.
    Barnett, H.I. & B.B. Hunter. 1972. Illustrated Genera of Imperfect Fungi, 3rd ed. Burgess Publishing Co., Minneapolis, Minn.Google Scholar
  4. 4.
    Barron, G.L. 1968. The Genera of Hyphomycetes from Soil. The Williams and Wilkins. Co., Baltimore.Google Scholar
  5. 5.
    Booth, C. 1971. The Genus Fusarium, Commonwealth Mycological Institute, Kew, Surrey, England.Google Scholar
  6. 6.
    Conant, N.F., D.T. Smith, R.D. Baker & J.L. Callaway. 1971. Manual of Clinical Mycology, p. 546. Third Ed. W.B. Saunders Co., Philadelphia.Google Scholar
  7. 7.
    Cordero-Moreno, R. (1973). Cited by Zapater & Arrechea, 1975..Google Scholar
  8. 8.
    de Campo et al. 1965. Cited by A.C. De Voe & M. Silva—Hutner, 1972.Google Scholar
  9. 9.
    De Voe, A.C. & M. Silva-Hutner. 1972. Fungal infections of the eye, p. 208–240. In D. Locatcher-Khorazo & B.C. Siegel (ed). Microbiology of the Eye. C.V. Mosby, St. Louis, Mo.Google Scholar
  10. 10.
    Drasenfield, M. 1966. The fungal air-spora at Samaru, Northern Nigeria. Trans. Brit. Mycol. Soc. 49: 121–132.Google Scholar
  11. 11.
    Fazakas, A. 1953. Zusammenfassender Bericht über meine Ophthalmologischen Pilzuntersuchungen. Ophthalmologica (Basel) 126: 91.Google Scholar
  12. 12.
    Greer, D.L., C. Brahim, L.A. Gonzalez. 1973. Queratitis micotica en Colombia. Trib. Med. 74: 15–20.Google Scholar
  13. 13.
    Gugnani, H.C., R.S. Talwar, A.N.U. Njoku-Obi & H.C. Kodilinye. 1976. Mycotic keratitis in Nigeria, a study of 21 cases. Brit. J. Ophthal. 60: 607–613.Google Scholar
  14. 14.
    Halde, C. & M. Okumoto. 1966. Ocular mycosis: a study of 82 cases. In Proc. International Congress of Ophthalmology, part 2, 705–712. 1966. International Congress series No. 146. Ecerpta Medical Foundation.Google Scholar
  15. 15.
    Hammeke, J.C. & P.P. Ellis. 1960. Mycotic flora of the conjunctiva. Amer. J. Ophthal. 19: 11–14.Google Scholar
  16. 16.
    Janke, R.G. & F. Schwab. 1961. Cited by A.C. De Voe and M. Silva—Hutner, 1972.Google Scholar
  17. 17.
    Joffe, A.Z. 1974. A modern system of Fusarium taxonomy. Mycopathologia 53: 201–228.Google Scholar
  18. 18.
    Jones, D.B., R. Sexton & G. Rebell. 1969. Mycotic keratitis in South Florida: A review of thirty-nine cases. Trans. Opthal. Soc. U.K. 89: 781–797.Google Scholar
  19. 19.
    Jones, B.R., D.B. Jones, A. Lim, A.J. Bron, G. Morgan & Y.M. Clayton. 1969. Corneal and intraocular infection due to Fusarium solani. Trans. Ophthal. Soc. U.K. 89: 757–779.Google Scholar
  20. 20.
    Lodder, J. (ed) 1970 The Yeasts 2nd ed Amsterdam. North Holland Press.Google Scholar
  21. 21.
    Locatcher-Khorazo, D., R.W. Benham and M. Silva-Hutner. Incidence of fungi from clinically healthy eyes in 509 young people 10–18 years of age and in 1,347 adults 19–80 years of age. Unpublished data. Cited by A.C. De Voe & M. Silva-Hutner, 1972.Google Scholar
  22. 22.
    Matsumoto, T. 1972. Keratomycosis. Jap. J. Med. Mycol. 13: 122–124.Google Scholar
  23. 23.
    Matsumoto, T. & N. Soejima. 1976. Keratomycosis. Mykosen 19: 217–222.Google Scholar
  24. 24.
    Mitsui, Y. & J. Hanabusa. 1955. Corneal infections after cortisone therapy. Brit. J. Ophthal. 39: 244.Google Scholar
  25. 25.
    Neema, H.V., O.P. Ahuja, A. Bal. & L.N. Mohapatra. 1966. Mycotic flora of the conjunctiva. Amer. J. Ophthal. 62: 968–970.Google Scholar
  26. 26.
    Nityananda, K., P. Sivasubramaniam & L. Ajello. 1962. Sabouraudia 2: 35. Cited by Jones et al, 1969.Google Scholar
  27. 27.
    Ogunlana, E.O. 1975. Fungal air spora at Ibadan, Nigeria. Appl. Microbiol 29: 458–463.Google Scholar
  28. 28.
    Ovsepian, T.L. & L.L. Osipian. 1965. Mycologic flora of the conjunctival sac. Zh. Eksp. Klin. Med. 5: 78.Google Scholar
  29. 29.
    Polack, F.M., H.E. Kaufman & E. Newmark. 1971. Keratomycosis. Medical and surgical treatment. Arch. Ophthal. 85: 410–416.Google Scholar
  30. 30.
    Raper, K.B. & D.I. Fennel. 1965. The Genus Aspergillus. The Williams & Wilkins Co., Baltimore.Google Scholar
  31. 31.
    Raper K.B. & C. Thorn. 1949. A Manual of the Penicillia. The Williams & Wilkins Co., Baltimore.Google Scholar
  32. 32.
    Rebell, G.C. & R.K. Forster. 1974. Fungi of keratomycosis in Manual of Clinical Microbiology, pp 482–490. Ed. E.H. Lennette, E.H. Spaulding & J.C. Truant. American Society for Microbiology, Washington.Google Scholar
  33. 33.
    Salceda, S.R. 1976. Fungi and the human eye. Kalikasan 5: 143–174.Google Scholar
  34. 34.
    Segal, E., A. Romano, E. Eylan & R. Stein. 1977. Fungus flora of the normal conjunctival sac. Mykosen 20: 9–14.Google Scholar
  35. 35.
    Segal, E., E. Eylan, T. Bentovim, R. Stein & A. Romano. 1974. Mycotic keratoconjunctivitis due to Aspergillus niger. Mykosen 17: 147–152.Google Scholar
  36. 36.
    Silva-Hutner, M. & B.H. Cooper. 1974. Medically important yeasts in Manual of Clinical Microbiology, pp 491–507. Ed. E.H. Lennette, E.H. Spaulding & J.C. Truant. American Society for Microbiology, Washington.Google Scholar
  37. 37.
    Sood, N.N., A. Ratnaraj, C. Balraman & H.N. Madhavan. 1968. Hypopyon ulcers — I. Orient. Arch. Ophthal. 6:Google Scholar
  38. 38.
    Subramaniam, C.V. 1971. Hyphomycetes, an account of Indian species, except cercosporae. Published by Indian Council of Agricultural Research, New Delhi.Google Scholar
  39. 39.
    Suga, K. 1972. Diagnosis and Theraphy of mycotic keratitis. Jap. J. Clin. Ophthal. 25: 1859–1866.Google Scholar
  40. 40.
    Vasquez de Parga, A.S. & M. Pereiro. 1965. Flora micotica de la conjunctiva. Arch. Soc. Oftal. Hisp. Amer. 25: 168. Cited by A.C. De Voe & M. Silva-Hutner, 1972.Google Scholar
  41. 41.
    Wilson, L.A., D.G., Ahearn, D.B. Jones & R. Sexton. 1969. Fungi from the normal outer eye. Amer. J. Ophthal. 67: 52–55.Google Scholar
  42. 42.
    Zapater, R.C. & A. Arrechea. 1975. Mycotic keratitis by Fusarium. A review and report of two cases. Ophthalmologica (Basel) 170: 1–12.Google Scholar

Copyright information

© Dr. W. Junk bv - Publishers 1978

Authors and Affiliations

  • H. C. Gugnani
    • 1
  • S. Gupta
    • 2
  • R. S. Talwar
    • 2
  1. 1.Department of MicrobiologyUniversity of NigeriaNsukkaNigeria
  2. 2.Department of OphthalmologyUniversity of Nigeria Teaching HospitalEnuguNigeria

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