Clinical and microbiological profile of infectious corneal ulcers and its seasonal trend in a tertiary care hospital of south west Bihar.

Abstract

Aim; To identify the microbiological profile and associated risk factors for microbial corneal ulcer in a tertiary care hospital of South West Bihar. Methods; In this prospective study conducted at Narayan Medical College and Hospital, Sasaram, Bihar, India. Total 61 patients with a clinical diagnosis of corneal ulcer were included. After detail history and slit lamp evaluation of corneal ulcer, corneal scraping was performed and subjected to microbiological analysis including Gram stain, potassium hydroxide(KOH) wet mount and bacterial and fungal culture. Results; Among total 61 patients included in our study, male to female ratio is almost equal and the most common affected age group was 41-60 years. Commonest profession affected was agriculture workers in 77% of cases and the commonest risk factor associated was trauma while working in agriculture fields in 44% of cases. The peak in the incidence of corneal ulcer cases were during harvesting of paddy crops in winter months. Forty eight percent of the ulcers were found to be culture positive. Among culture positive patients 79% were fungal and rest 21% were bacterial. Fusarium spp was the most common fungal isolate(48%) followed by Aspergillus spp (26%).Among bacteria S. aureus was the most common organism(66.6%) isolated. Conclusion; :- In our study, we found that that in region of south west Bihar , fungal (specially Fusarium spp) corneal ulcers predominate, as the majority of patients present with a history of antecedent vegetative trauma mainly during harvesting of paddy crops in winter season. Managing infective suppurative corneal ulcers with timely and appropriate antimicrobial therapy will help to prevent the cases of corneal ulcer and it’s sequel.

Key words: Corneal ulcer, Microbiological profile, Fusarium, Seasonal trend