Fusarium sacchari, a cause of mycotic keratitis among sugarcane farmers – a series of four cases from North India

Abstract

The two most common filamentous fungi causing mycotic keratitis are Aspergillus and Fusarium spp. Around 70 Fusarium spp. are involved in causing human infections. In this study, four cases of keratitis in sugarcane farmers in India are being reported, caused by the sugar cane pathogen Fusarium sacchari, a species of the Fusarium fujikuroi species complex. Fusarial keratitis was established by potassium hydroxide/Calcofluor white wet mounts and fungal culture of corneal scrapings on conventional media. Final identification was done by genetic sequencing at CBS-KNAW, Utrecht, The Netherlands. The antifungal susceptibility testing was done using broth microdilution method as per CLSI document M38-A2. Four cases of F. sacchari keratitis were identified. Three of them had trauma with sugarcane leaves, whereas one sugarcane farmer reported trauma by vegetative matter. The morphological similarities among various Fusarium species warrant use of molecular methods for identification of cryptic species. A wide distribution of sugarcane farming could be the possible explanation for emergence of F. sacchari keratitis in India.

Molecular identification of Fusarium species complex isolated from clinical samples and its antifungal susceptibility patterns

“…Out of these four patients, three cases specifically reported trauma with sugarcane leaf (F. sacchari is a known pathogen in sugarcane farming). All of these cases were reported from two neighboring districts of Haryana raising suspicion of endemic focus in the region for this fungus [28].…”

Multidrug‐resistant Fusarium in keratitis: a clinico‐mycological study of keratitis infections in Chennai, India

“…In tropical developing countries such as India, males, especially field labourers and factory workers may be more at risk for fungal keratitis, secondary to trauma at their workplace . Recent reports suggest the emergence of keratitis by F. sacchari , a member of the Fusarium fujikuroi species complex (FFSC) among sugarcane farmers in North India . Therefore, protective eye wear should be recommended for people at risk for these types of injuries.…”

“…16 Recent reports suggest the emergence of keratitis by F. sacchari, a member of the Fusarium fujikuroi species complex (FFSC) among sugarcane farmers in North India. 17 Therefore, protective eye wear should be recommended for people at risk for these types of injuries. Among our cases of Fusarium keratitis, trauma by vegetation and splinter injury was found to be a consistent cause followed by diabetes mellitus.…”

Virome Identification and Characterization of Fusarium sacchari and F. andiyazi: Causative Agents of Pokkah Boeng Disease in Sugarcane

“…Pokkah boeng disease (PBD) is an airborne fungal disease caused by Fusarium fujikuroi species complex (FFSC) and is responsible for severe yield losses in susceptible varieties of sugarcane worldwide. The FFSC species F. sacchari is associated with both PBD and sugarcane wilting (Viswanathan et al, 2017) as well as fruit rot disease in bananas (Abd Murad et al, 2017), spear rot of oil palm (Suwandi et al, 2018), and even mycotic keratitis among sugarcane farmers (Bansal et al, 2016). The FFSC species F. andiyazi has been reported to cause wheat head blight (Wang et al, 2015), ear rot of maize (Bandara et al, 2017), and stalk rot of sorghum (Zhang et al, 2014).…”