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Fungal keratitis among children in North India

May 20 2020

Fungal infections of the cornea (keratitis) can cause loss of vision, but the epidemiology of infections in North India has been relatively understudied.

Dr Manisha Singh and colleagues present a series of 104 cases of infectious keratitis in children (<16 years) attending an eye hospital in New Delhi (North India).

  • Of 100 cases in which Gram and KOH smears were performed, microbes were identified in 76%: bacteria alone (40%); fungi only (25%); acanthamoeba only (3%); both bacteria and fungi (8%).
  • The bacteria most frequently identified by culture were Staphylococcus (24 cases), Streptococcus (11 cases) and Pseudomonas (6 cases).
  • The fungi most frequently identified by culture were Fusarium (14 cases), Aspergillus (9 cases) or unidentified dematiaceous (brown-pigmented) fungi (6 cases).
  • Fungal infections took longer on average to resolve,
  • Fungal infections were treated with 5% natamycin, with the addition of 1% voriconazole in certain cases (ulcers involving posterior stroma, limbus threatening ulcers, and postpenetrating keratoplasty).

The authors recommend that direct microscopy with KOH should be introduced at an earlier stage of care, for example by fellows in secondary care settings

Read the paper: Singh et al (2020) Demographic details, risk factors, microbiological profile, and clinical outcomes of pediatric infectious keratitis cases in North India