The incidence of fungal keratitis in Zagazig University Hospitals, Egypt and the value of direct microscopy and PCR technique in rapid diagnosis
Journal Title: Journal of Microbiology and Infectious Diseases - Year 2013, Vol 3, Issue 4
Abstract
Objective: To determine the frequency and risk factors of fungal keratitis (FK) and the value of direct microscopy and PCR techniques of corneal smears as appropriate diagnostic methods. Methods: The keratitis cases in Ophthalmology Department of Zagazig University Hospitals, between January and June 2012 were enrolled. Corneal samples were examined by direct microscopic examination of wet mount preparation with KOH (10%), PCR technique and cultured simultaneously. The corneal smear and PCR findings were compared to the culture results to analyze specificity, sensitivity and predictive values of these techniques. Results: A total of 350 patients diagnosed as keratitis and 60 of them were included in the study by a systemic random sampling method. The FK was proven in 33 (55%) cases with culture results. Ocular trauma (63.6%) was the most prevalent predisposing factor. The cultures revealed that the most frequent fungal pathogen were Penicillium spp. (24.2%) followed by Aspergillus fumigatus (21.2%). Direct microscopic examination had a sensitivity of 100%, specificity of 66.7%, a positive predictive value (PPV) of 78.6% and a negative predictive value (NPV) of 100%. PCR had a sensitivity of 100%, specificity of 88.9%, a PPV of 91.7% and a NPV of 100%. Conclusion: Although, PCR is able to detect fungi in a high proportion of culture negative cases, it is difficult to be used as a routine diagnostic test due to the economic reasons. Therefore, we strongly recommend the use of direct microscopy of corneal smear as a rapid, economic and sensitive method for screening of FK. J Microbiol Infect Dis 2013;3(4): 186-191 Key words: Fungal keratitis, incidence, predisposing factors, rapid diagnose, direct microscopy, PCR
Authors and Affiliations
Reham EL Shabrawy, Nissreen El Badawy, Ashraf Harb
Keywords
Related Articles
- EP ID EP157255
- DOI 10.5799/ahinjs.02.2013.04.0106
- Views 143
- Downloads 0
Epidemiology and Antimicrobial Susceptibility of Anaerobic Bloodstream Infections: A 10 Years Study
Epidemiology and Antimicrobial Susceptibility of Anaerobic Bloodstream Infections: A 10 Years Study Nadeem Sajjad Raja Department of Microbiology, East Sussex Healthcare Trust, Hastings, England, UK ABSTRACT Objective:...
Cerebellar involvement that occurred during treatment of Legionella pneumonia: A case report
Legionnaires’ disease can appear with different levels of severity. A case of a previously healthy lady with communityacquired pneumonia who progressed to severe acute respiratory distress syndrome and developed cerebel...
Mycobacterium tuberculosis’in Neden Olduğu Bir Akut Dissemine Ensefalomiyelit Olgusu
Akut dissemine ensefalomiyelit (ADEM) santral sinir sisteminde beyaz cevherin multifokal tutulumuyla karakterize enflamatuvar ve demiyelizan bir hastalığıdır. 27 yaşında, dört gün önce başka bir hastanede seze...
HIV associated Mycobacterium colombiense cervical lymphadenitis: A case report
We report a case of Mycobacterium colombiense in a human immunodeficiency virus (HIV) positive patient who presented with tender cervical lymphadenopathy that progressed to a fistulous tract. The identification, treatmen...
Hemorrhagic Fevers with Renal Syndrome Presenting with Pregnancy Interruption
Hemorrhagic fever with renal syndrome is presented with so many different clinical symptoms. It can present mild form of the disease or the severe symptoms. We reported two cases with HFRS, at pregnant women, ended with...