A Comparative Study of Potassium Hydroxide Wet Mount, Calcofluor White Staining and Culture for the Diagnosis of Keratomycosis

Abstract

Background: The incidence of keratomycosis has increased dramatically in recent years. Early diagnosis and treatment of keratomycosis are important in preventing further complications. Direct microscopic techniques are time-saving for diagnosing keratomycosis when compared to culture methods. This study was carried out to determine the sensitivities of potassium hydroxide (KOH) wet mount, Gram stain and Calcofluor white (CFW) stain plus KOH wet mount by taking culture as the gold standard. Methods: Corneal scrapings were collected from 150 clinically suspected patients with keratomycosis. Demographic profile was collected and analyzed. Results: Of these patients, 67.33% were male, 24% were in the age group of 51-60 years, 70% were ruralresidents, 44% were agricultural workers, and 60% presented with a history of corneal trauma. Laboratory investigations have revealed that 29.33% (44 cases) were culture positive. In other words, Fusarium spp. was isolated in 17 cases, Aspergillus spp. in 14 cases, phaeoid fungi in 3 cases and unidentified fungi in 10 cases. The positivity of CFW stain plus KOH wet mount, KOH wet mount, and Gram stain was 30%, 23.3%, and 20%, respectively. Sensitivities of CFW stain plus KOH wet mount, KOH wet mount, and Gram stain were 79.55%, 54.55%, and 47.62%, respectively. Conclusion: Post-investigative analysis has revealed that CFW stain plus KOH wet mount was better than KOH wet mount alone in demonstrating fungal pathogens. Therefore, early diagnosis of keratomycosis by meticulous examination of corneal scrapings by direct microscopy specifically using CFW stain plus KOH wet mount and institution of antifungal therapy may limit ocular morbidity and disastrous sequelae among these patients.

Rapid diagnosis of fungal keratitis in patients with corneal ulcer using Calcofluor White stain

“…The most frequent predisposing factor related to infectious keratitis in the current research was corneal trauma, with 14 (46.6%) cases, followed by steroid use, with 6 (20%), and DM, with 3 (10%). This came in agreement with a study conducted by Harbiyeli et al [27], Alekhya et al [28], and Mahmoud et al [29]. On the other hand, other publications showed different results as a study conducted by Gorski et al [30] who found that among 155 patients with microbial keratitis, contact lens wear was (39%) followed by corneal trauma (8%).…”

Copper iodide microhexagons: a potential therapeutic agent for surface microbial infection and melanoma

“…The samples were then mounted using a coverslip and imaged using a live cell imager. 35,36 2.5 Antiviral efficacy of CuI (WH) and CuI (H) particles 2.5.1 Culturing and maintenance of lambda phage (U). The bacteriophage lambda (ATCC 23724-B2) was received as a gift sample from Dr Manjula Reddy, CSIR-CCMB, Hyderabad, India.…”

“…The samples were then mounted using a coverslip and imaged using a live cell imager. 35,36 2.5 Antiviral efficacy of CuI (WH) and CuI (H) particles…”