Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Ophthalmology
Published in: BMC Ophthalmology 1/2016

Open Access 01-12-2016 | Research article

Fungal keratitis in patients with corneal ulcer attending Minilik II Memorial Hospital, Addis Ababa, Ethiopia

Authors: Tihtina Kibret, Adane Bitew

Published in: BMC Ophthalmology | Issue 1/2016

Login to get access

Abstract

Background

Fungal keratitis is an important cause of corneal blindness all over the world. Although there are several reports on fungal keratitis from developing and developed countries, fungal keratitis in Ethiopia is poorly known. The aim of this study was to determine the prevalence of fungal keratitis and spectrum of fungi implicated in causing the infection.

Methods

The present study was a single institutional cross-sectional study carried out in Minilik II Memorial Hospital eye clinic, Addis Ababa, Ethiopia from September 2014 to August 2015. Corneal scraping was obtained under aseptic condition with sterile 21 gauge needle by an ophthalmologist from patients suspected of microbial keratitis. Each scraping was inoculated onto Sabouraud Dextrose Agar in C-shaped streaks and incubated at 25 °C aerobically for four weeks. Cultures of mycelia fungi were identified by examining macroscopic and microscopic characteristics of their colonies. Yeasts were identified by employing biochemical and assimilation test procedures and using CHROMagar Candida culture. All data were coded, double entered and analyzed using SPSS version 20.

Result

Out of 153 cases of microbial keratitis, fungi were recovered from 69 patients giving fungal keratitis prevalence of 45.1. Patients from rural areas were significantly affected than patients in urban regions (P = 0.005). Age groups of 25–34 (P = 0.017) and 15–24 years (P = 0.008) were significantly affected. Fungal keratitis was significantly associated with farmers (P = 0.0001), daily laborers (P = 0.0001), unemployed (P = 0001) and students (P = 0.004). Fungal keratitis was statistically associated with trauma (P = 0.006), and diabetes (P = 0.024). Seventy six fungal isolates were recovered, of which molds accounted 63 (82.9 %) of the total isolates. Fusarium and Aspergillus species were the two predominant molds accounting 27.6 and 25 % of the total isolates respectively. Yeast isolates accounted only 17.1 %.

Conclusion

High prevalence of fungal keratitis recorded in the present study, highlights the need for nationwide study on fungal keratitis and precise identification of the causative fungi and institution of appropriate treatment strategy.
Literature
1.
Stapleton F, Keay LJ, Sanfilippo PG, Katiyar S, Edwards KP, Naduvilath T. Relationship between climate, disease severity, and causative organism for contact lens-associated Microbial Keratitis in Australia. Am J Ophthalmol. 2007;144:690–8.CrossRefPubMed
2.
Xie L, Hu J, Shi W. Treatment failure after lamellar keratoplasty for Fungal Keratitis. Ophthalmol. 2008;115:33–6.CrossRef
3.
Bharathi MJ, Ramakrishnan R, Meenakshi R, Padmavathy S, Shivakumar C, Srinivasan M. Microbial keratitis in South India: influence of risk factors, climate, and geographical variation. Ophthalmic Epidemiol. 2007;14:61–9.CrossRefPubMed
4.
Panda A, Sharma N, Das G, Kumar N, Satpathy G. Mycotic keratitis in children epidemiologic and microbiologic evaluation. Cornea. 1997;16:295–9.CrossRefPubMed
5.
Thomas PA, Kaliamurthy J. Mycotic keratitis: epidemiology, diagnosis and management. Clin Microbiol Infect. 2013;19:210–20.CrossRefPubMed
6.
Nielsen SE, Nielsen E, Julian HO, Lindegaard J, Højgaard K, Ivarsen A, et al. Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013. Acta Ophthalmol. 2015;93:54–8.CrossRefPubMed
7.
Houang E, Lam D, Fan D, Seal D. Microbial keratitis in Hong Kong, relationship to climate, environment and contact-lens disinfection. Trans Roy Soc Trop Med Hyg. 2001;95:361–7.CrossRefPubMed
8.
Alfonso EC, Forster RK, Garg P. Fungal infections. In: Foster CS, Azar DT, Dohlman CH, editors. Smolin and Thoft’s The Cornea Scientific Foundations & Clinical Practice. 4th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005. p. 405–16.
9.
Agarwal PK, Roy P, Das A, Banerjee A, Maity PK, Banerjee AR. Efficacy of topical and systemic itraconazole as broad-spectrum antifungal agents in mycotic corneal ulcer: A preliminary study. Indian J Ophthalmol. 2001;49:173–6.PubMed
10.
Agarwal V, Biswas J, Madhavan HN, Mangat G, Reddy MK, Saini JS, et al. Current perspectives in infectious keratitis. Indian J Ophthalmol. 1994;42:171–91.
11.
12.
Tanure MA, Cohen EJ, Sudesh S, Rapuano CJ, Laibson PR. Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea. 2000;19:307–12.CrossRefPubMed
13.
Ritterband DC, Seedor JA, Shah MK, Koplin RS, McCormick SA. Fungal keratitis at the New York eye and ear infirmary. Cornea. 2006;25:264–7.CrossRefPubMed
14.
Tuft SJ, Tullo AB. Fungal keratitis in the United Kingdom 2003–2005. Eye (Lond). 2009;23:1308–13.CrossRef
15.
Kern M. Medical mycology, a self-instructional text. Philadelphia, F. D Davis Company, 2nd ed. 1985.
16.
Garg P, Gopinathan U, Choudhary K, Rao GN. Keratomycosis: Clinical and Microbiologic Experience with Dematiaceous Fungi. Ophthalmol. 2000;107(57):4–8.
17.
Shokohi T, Dailami KN, Haghighi TM. Fungal Keratitis in Patients with Corneal Ulcer, in Sari, Northern Iran. Arch Iranian Med. 2006;9:222–7.
18.
Ak N, Nangdev PR, Surhio SA, Mahesh Kumar M, Jatoi SM. Demographic Pattern, Risk Factors, Clinical and Microbiological Characteristics of Fungal Keratitis. JLUMHS. 2012;11:42–6.
19.
Fong CF, Tseng CH, Hu FR, Wang IJ, Chen WL, Hou YC. Clinical characteristics of microbial keratitis in a University Hospital in Taiwan. Am J Ophthalmol. 2004;137:329–36.CrossRefPubMed
20.
Mirshahi A, Ojaghi H, Aghashahi D, Jabarvand M. Fungal keratitis in patients at Farabi Hospital, Tehran. Bina. 1999;5:135–43.
21.
Javadi MA, Hemati R, Muhammadi MM, Farsi A, Karimian F, Einolahi B, et al. Causes of fungal Keratitis and its management. Review of 23 cases from Labafinejad Medical Center (LMC). Bina. 1996;2:38–54.
22.
Upadahyay MP, Murthy GV. Epidemiologic characteristics, predisposing factors and etiologic diagnosis of corneal ulceration in Nepal. A J O. 1991;111:92–9.
23.
Kunimoto DY, Sharma S, Garg P, Gopinathan U, Miller D, Rao GN. Corneal ulceration in the elderly in Hyderabad, south India. Br J Opthalmol. 2000;84:54–9.CrossRef
24.
Schaefer Frederic, Olivier Bruttin, Zagrafos. Bacterial keratitis: A prospective clinical and microbiological study. B J Ophthalmol. 2001; 85: 842–847.
25.
Srinivasan M, Gonzales CA, Gerge CA. Epidemiology and etiological diagnosis of corneal ulceration in Medurai south India. Br J Ophthamol. 1997;81:965–71.CrossRef
26.
Xie L, Zhong W, Shi W, Sun S. Spectrum of fungal keratitis in north China. Ophthalmology. 2006;113:1943–194.CrossRefPubMed
27.
Ibrahim MM, Vanini R, Ibrahim FM, Wde P, Carvalho RT. Epidemiology and medical prediction of microbial keratitis in southeast Brazil. Arq Bras Of talmol. 2011;74:7–12.
28.
29.
Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Palaniappan R. Epidemiological characteristics and laboratory diagnosis of fungal keratitis: A three-year study. Indian J Ophthalmol. 2003;51:315–21.PubMed
30.
Ferrer C, Colom F, Frases S, Mulet E, Abad JL, Jose L, et al. Dectection and identification of fungal pathogens by PCR and by ITS2 and 5.8S ribosomal DNA typing in ocular infections. J Clin Microbiol. 2001;39:2873–9.CrossRefPubMedPubMedCentral
31.
Chowdhary A, Singh K. Spectrum of fungal keratitis in north India. Corena. 2005;24:8–15.CrossRef
32.
Gopinathan U, Sharma S, Garg P, Rao GN. Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: Experience of over a decade. Indian J Ophthalmol. 2009;57:273–9.CrossRefPubMedPubMedCentral
Metadata
Title
Fungal keratitis in patients with corneal ulcer attending Minilik II Memorial Hospital, Addis Ababa, Ethiopia
Authors
Tihtina Kibret
Adane Bitew
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2016
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-016-0330-1

Other articles of this Issue 1/2016

BMC Ophthalmology 1/2016 Go to the issue

Research article

Systematic literature review of treatments for management of complications of ischemic central retinal vein occlusion

Research article

Refractive error characteristics in patients with congenital blepharoptosis before and after ptosis repair surgery

Case report

Chronic post-operative iris prosthesis endophthalmitis in a patient with traumatic aniridia: a case report

Research article

Short-term changes of intraocular pressure and ocular perfusion pressure after intravitreal injection of bevacizumab or ranibizumab

Research article

A retrospective analysis of eleven cases of invasive rhino-orbito-cerebral mucormycosis presented with orbital apex syndrome initially

Case report

Peripapillary gamma zone pit as dehiscence between Elschnig´s border tissue and Bruch´s membrane with herniation and defect of the retinal nerve fiber layer