Fungal keratitis at the New York eye and ear infirmary 1988-1995

Purpose. To study the incidence and clinical outcome of patients with fungal keratitis. Methods. The microbiology lab records for all corneal ulcers cultured between April 1988 and November 1995 were reviewed. In those cases where fungal keratitis was diagnosed, a chart review was performed to delineate treatment, and visual outcome. Results. During the study period therewere 2,294 positive corneal cultures, of which 19 were fungal (19/2,294 = 0.8%). Of the 19 cases, 15 occurred in female patients(79%). Candida albicans accounted for 10/19 cases (53%). Besides C. albicans, only Fusarium solani was identified more than once (2/19,11%). Newly identified species included Colletotrichum graniculum and Wangiella dermatitidis. Neither fungus has previously been reported to cause ocular disease. 6 patients (32%) required penetrating keratoplasty; 3 of which had recurrences in the graft. One patient required enucleation. Trauma was the most commonly associated risk factor but accounted for only 3 cases. No cases were due to agricultural injuries. All of the Candida species were identified in eyes with predisposing factors: i.e., trauma, immunosuppression. # Cases # Cases # Cases Candida albicans 10 Aspergillus fumigatus 1 Torulopsis glabrata 1 Candida parapsilosis 1 Cryptococcus neoformans 1 Colletotrichum graniculum 1 Aspergillus f1avus 1 Fusarium solani 2 Wangiella dermatitidis 1 Conclusions. In contrast to previous reports, the majority of patients in our series were female. Candida species (albicans and parapsilosis) emerged as the most common isolates (58%), which correlated with other series from the northern United States. Of interest was the low incidence of preceding trauma in our series.