Fungal etiology and outcome of ocular diseases in patients attending a tertiary care hospital in Eastern Rajasthan

Vijalatha  Rastogi; Pushpanjali Verma; Abhila Parashar; Rakesh Porwal; Bhavana Jorawat

Volume : V, Issue : VII, July - 2016

Fungal etiology and outcome of ocular diseases in patients attending a tertiary care hospital in Eastern Rajasthan

Vijalatha Rastogi, Pushpanjali Verma, Abhila Parashar, Rakesh Porwal, Bhavana Jorawat

Abstract :

Context: Corneal disease is the second most common cause of blindness after cataract and infectious keratitis is one of the predominant cause. The incidence of fungal keratitis is more than 50% in tropical and sub tropical countries. However, distribution may vary considerably depending upon ethnogeographic and individual patient factors. It is essential to determine the local etiological profile of ocular mycosis to enable appropriate choice of therapeutics and management. Aims: To know the fungal etiology and clinical outcome of ocular mycosis in patients attending a tertiary care hospital in Eastern Rajasthan. Materials and Methods: Ocular samples from 90 clinically suspected patients over a period of two years were processed for mycological diagnosis. Fungal identification was done by standard conventional methods. Antifungal susceptibility testing with fluconazole (25�g) and voriconazole (1�g) was done for yeast isolates by disk diffusion and automated oth dilution method using Vitek 2C (Biomerieux, France). Results: Fungal etiology was established in 43.33%cases. Positivity rate was highest in cases of fungal keratitis. Filamentous fungi were the commonest with predominant Aspergillus spp. (37.04%) and Fusarium spp.(18.52%). Trauma was seen to be the most common predisposing factor. In follow up 71.42% of the fungi positive cases responded well to fungal eye drops (natamycin 5% / fluconazole 0.2% / voriconazole 1% ) with or without oral fluconazole(150 mg) / itraconazole(100 mg) BD for 15 days. Conclusions: This study reveals fungal keratitis as the most prevalent ocular infection in our region. In order to enable better management of disease relating to eye , increased clinical suspicion, better sampling rate and availability of rapid methods for fungal diagnosis is imperative.