Causative agents of keratomycosis in Ibadan: review of laboratory reports

Abstract

Introduction: Fungi are responsible for less than 2.0 % of corneal infection around the globe. Trauma to the cornea is the leading cause of fungal keratitis especially with history of corneal trauma with vegetable or organic matter. Because of the dearth of data on the aetiological agents of Keratomycosis in this hospital, this study was aimed at finding the prevalence and fungal etiological agents responsible for this condition Ibadan, Nigeria. Methods: A retrospective review of the laboratory reports of corneal scrapings of patients that presented with signs and symptoms suggestive of Keratomycosis was carried out. The scrapings were subjected to wet preparation with 10.0 % KOH, Gram staining and Giemsa staining to rule out inclusion bodies. The diagnosis of Keratomycosis was made on the basis of the recognizable and characteristic appearance of fungal hyphae and fruiting bodies under microscopy. The media with no obvious growth after 3-4 weeks of incubation were regarded as negative. Results: A total of 48 specimens from patients with suspected diagnosis of Keratomycosis were included in the analysis. The patients consisted of 42 (87.3%) males and 6 (12.5%) females. The ages at diagnosis ranged from 3 to 73 years with a mean of 36.46 years and a median of 35.5 years. The prevalence of Keratomycosis among this group of patients in this hospital was 8.4 %. Candida albicans and Fusarium spp were the fungal isolates in these patients as it occurred in 4.2 % (2/48) of them respectively. Conclusions: Corneal scarring due to trauma or infections is a major cause of monocular blindness, especially in developing countries like Nigeria. Despite the low level of Keratomycosis in this study, high index of suspicion of possible diagnosis should be giving to patients with history of trauma, tissue devitalization with topical steroids and immunocompromised immunity.

Keywords: Keratomycosis, Corneal, Fusarium and Candida.