Pattern of fungal isolates in cases of corneal ulcer in the western periphery of Nepal

Abstract

Purpose: To find out the epidemiologic features in 686 consecutive cases of fungal keratitis presenting in a tertiary eye hospital in the western region of Nepal. Materials and methods:A prospective hospital -based study was carried out on 1880 consecutive patients presenting with corneal ulcer in the outpatient department and cornea clinic of Lumbini Eye Institute, Bhairawa, Nepal. The socio-demographic data, predisposing risk factors, prior treatment modalities, laboratory results and the distribution pattern of fungus species were analyzed.Results: Diagnosis of fungus keratitis was established in 686 (36 %) out of the total study group of 1880 cases. The spectrum of fungi isolated were Fusarium species (Fusarium spp.) in 219 (31.9 %), followed by unidentified dematiaceous 151 (22 %), curvularia 122 (17.7 %) and unidentified hyaline in 111 cases (16.1 %). Men (59.3 %) were more commonly affected than women (40.6 %). The young adults age group of 31-40 years was most commonly involved (26.6 %). Corneal trauma (58 %) and topical steroids (12 %) were the most common predisposing risk factors noted. Conclusion:In contrast to the other studies done in Nepal, we found Fusarium to be the most common fungal isolate causing corneal ulcer followed by unidentified dematiaceous, unidentified hyaline and curvularia. Corneal trauma was the commonest predisposing risk factor in causing fungal keratitis.

Spectrum of Mycotic corneal ulcers in Mid Western peripheral region of Terrain belt of Nepal and Indo-Nepal Border

“…Our study correlates well with a similar study done in Nepal earlier in the western peripheral terrain belt of Nepal and Indo-Nepal border 24 Ghana and southern India. 25 Where 32% and 39.9 % of cases were due to fusarium species respectively.…”

“…The higher incidence of fusarium species may be due to the widespread cereal-crop cultivation in this region. 24 Curvularia species were found to be more prevalent in our study (17.89 %) than in the study done in Ghana and Southern India in which the prevalence was 9.6 %. 22 In a similar study from Nepal 24 curvularia species were found to be more prevalent, which correlated well with this study.…”

“…Though, there has been already a report on culture positive fungal microbial keratitis from western terrain belt of Nepal, 24 we believe the difference in geographical location and economic status plays a sufficiently important role to warrant the setup of our present study and helps in finding out the variation in the fungal isolates. Importantly, this study had more study subjects and more number of pure fungal isolates.…”

“…22 In a similar study from Nepal 24 curvularia species were found to be more prevalent, which correlated well with this study. 24 In another study done in northern part of India, aspergillus species were found to be the most common fungal isolate accounting for 41 % of cases. Though, in our study aspergillus species accounted for 12.50% of all pure fungal isolates.…”

“…25 Where 32% and 39.9 % of cases were due to fusarium species respectively. 24,25 The fusarium species are common plant pathogens particularly of cereal crops and saprophytes of plant debris and are found in soil. The higher incidence of fusarium species may be due to the widespread cereal-crop cultivation in this region.…”