Summary
Fungal corneal ulcer is common in India due to the tropical climate and a large agrarian population that is at risk. Various factors such as trauma, the injudicious use of topical antibiotics and corticosteroids are involved. Many of the age and sex-related risk factors also play a minor role. This 6-year study from Northern India revealed that fungi were detected in 61 (8.4%) out of 730 patients investigated. Direct microscopy was positive in 51 (7%) and culture in 53 (7.3%) patients.Aspergillus spp. were the most common causative agents accounting for 25 (40.1%) of the isolates, followed byFusarium sp. with ten (16.4%),Curvularia sp. with five (8.2%),Candida albicans with five (8.2%),Acremonium sp. with four (6.6%),Paecilomyces sp. with three (4.9%),Penicillium sp. with two (3.3%),Alternaria sp. with two (3.3%),Fonsecaea pedrosoi var.cladosporium with two isolates (3.3%) andPseudallescheria boydii, Drechslera sp. andAureobasidium pullulans with one isolate (1.6%) each. The prevalence of fungal ulcers in males was three times higher than in females. The affected individuals had a rural background and were in the 51–60 year age group.
Zusammenfassung
Mykotische Hornhautulzera werden in Indien wegen des tropischen Klimas und einer großen bäuerlichen Bevölkerungsgruppe mit erhöhtem Risiko häufig beobachtet. Trauma, unkritische Anwendung von topischen Antibiotika und Kortikosteroiden fördern die Entstehung der Ulzera; eine untergeordnete Rolle nehmen auch alters- und geschlechtsspezifische Risikofaktoren ein. In der vorliegenden Studie, die über sechs Jahre in Nordindien durchgeführt wurde, wurde bei 61 von 730 untersuchten Patienten mit Hornhautulkus eine Pilzätiologie nachgewiesen (8.4%). In 51 Fällen erfolgte der Erregernachweis direkt mikroskopisch (7%), in 53 Fällen (7,3%) war die Pilzkultur positiv.Aspergillus spp. waren die häufigsten Erreger, sie waren für 25 (40.1%) der 61 Fälle verantwortlich. Es folgtenFusarium sp. mit 10 (16,4%),Curvularia sp. mit fünf (8,2%),Candida albicans mit fünf (8,2%),Acremonium sp. mit vier (6,6%),Paecilomyces mit drei (4,9%),Penicillium sp. mit zwei (3,3%),Alternaria sp. mit zwei (3,3%),Fonsecaea pedrosi var.cladosporium mit zwei Isolaten (3,3%) undPseudoallescheria boydii, Drechselera sp. undAurobasidium pullulans mit je einem Isolat (1,6%). Bei Männern war die Prävalenz an mykotischen Hornhautulzera dreimal so hoch wie bei Frauen. Die betroffenen Personen kamen aus einer bäuerlichen Umgebung und waren vorwiegend in der Altersgruppe zwischen 51 und 60 Jahren.
References
Mino de Kaspar, H., Zoulek, G., Paredes, M. E., Alborno, R., Medina, D., Centurion de Moringio, M., Ortiz de Fresco, M., Aguero, F. Mycotic keratitis in Paraguay. Mycoses 34 (1991) 251–254.
W. H. O. Weekly Epidemiol. Rec. 64 (1989) 216–218.
Upadhyay, M. P., Karmacharya, P. C. D., Koirala, S., Tuladhar, N. R., Bryan, L. E., Smolin, D., Whitcher, J. P. Epidemiologic characteristics, predisposing factors and etiological diagnosis of corneal ulceration in Nepal. Am. J. Ophthalmol. 111 (1991) 92–99.
Harris, D. J., Stulting, R. D., Waring, G. O., Wilson, L. A. Late bacterial and fungal keratitis after corneal transplantation. Ophthalmology 95 (1988) 1450–1457.
Wilhelmus, K. R., Robinson, N. M., Font, R. A., Hamill, M. B., Jones, D. B. Fungal keratitis in contact lens wearers. Am J. Ophthalmol. 106 (1988) 708–714.
Stern, G. A., Buttross, M. Use of corticosteroids in combination with antimicrobial drugs in the treatment of infectious corneal diseases. Ophthalmology 98 (1991) 847–853.
Kwon-Chung, K. J., Bennett, J. E. Medical mycology (1st ed.). Lea & Febiger, Philadelphia 1992, pp. 162–169.
Monheit, J. G., Cowan, D. F., Moore, D. G. Rapid detection of fungi in tissues using Calcofluor white and fluorescent microscopy. Arch. Pathol. 108 (1984) 616–618.
Rippon, J. W. Medical mycology. The pathogenic fungi and the pathogenic actinomycetes (2nd and 3rd eds.). W. B. Saunders Co., Philadelphia 1982 and 1988.
Narsing, A. R. laboratory approach to rapid diagnosis of ocular infections and prospects for the future. Am. J. Ophthal. 107 (1989) 283–289.
Leber, T. Keratomycosis aspergillina als Ursache von Hypopyon-Keratitis. Graefes Arch. Clinic Exp. Ophthalmol. (Berlin) 25 (1879) 285–301.
Venugopal, P. L., Venugopal, T. L., Gomathi, A., Ramakrishana, E. S., Ilavarasi, S. Mycotic keratitis in Madras. Indian J. Pathol. Microbiol. 32 (1989) 190–197.
Sundaram, B. M., Badrinath, S., Subramanian, S. Studies on mycotic keratitis. Mycoses 32 (1989) 568–572.
Talwar, P., Sehgal, S. C. Mycotc infections of the eyes in Chandigarh and neighbouring areas. Indian J. Med. Res. 67 (1978) 929–933.
Reddy, P. S., Satyendran, O. N., Satpathy, M., Kumar, H. V., Reddy, P. R. Mycotic keratitis. Indian J. Ophthal. 20 (1972) 101–108.
Puttanna, S. J. Primary keratomycosis. J. All India Ophthal. Soc. 17 (1969) 171–200.
Sharma, S. L., Bajaj, R., Sharma, R. Keratomycosis in corneal sepsis. Indian J. Ophthalmol. 35 (1987) 143–145.
Subbannayya, K., Mamatha, B., Jyothirlatha, Kumar, A., Srinivasa Rao, P. N., Shivenanda, P. G. Mycotic keratitis: a study in coastal Karnataka. Indian J. Ophthal. 40 (1991) 31–33.
Dasgupta, L. R., Gupta, A. K., Ghosh Roy, B., Sunderraj, T., Ramamurthy, S., Lambo, P. A. Mycological studies in keratitis. Indian J. Med. Res. 61 (1973) 165–168.
Singh, S. M., Khan, R., Sharma, S., Chatterjee, P. K. Clinical and experimental mycotic corneal ulcer caused byAspergillus fumigatus and the effect of oral ketoconazole in the treatment. Mycopathologia 106 (1989) 133–141.
Haldar, K. K., Benerjee, A. R., Chakarbarti, A. K., Basak, S. Primary mycotic keratitis among tea garden workers. Indian J. Med. Microbiol. 10 (1992) 38–43.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chander, J., Sharma, A. Prevalence of fungal corneal ulcers in Northern India. Infection 22, 207–209 (1994). https://doi.org/10.1007/BF01716706
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01716706