Abstract
Abstract: :
Purpose: To analyze the frequency and the etiology of mycotic infectious eye diseases diagnosed by culture at the Ocular Diseases Laboratory of the Federal University of Sao Paulo (LOFT–UNIFESP), Sao Paulo, SP, Brazil, and the risk factors associated with fungal keratitis. Methods: We retrospectively analyzed the 14.391 laboratorial solicitations of infectious eye diseases between 1975 and May 2003. For the fungal culture proven exams we observed the morphologic type of the isolated fungus, the gender and age of the patients, the site of ocular involvement, and the associated factors with keratitis cases, according to the etiologic agent. Results were considered significant if p< .05. Results: We verified 296 ocular mycosis cases with 265 keratitis (89,5%), 27 intraocular infections (9,1%), and 4 infections at other sites (1.3%). Filamentous fungi were isolated in 233 cases (78,7%) being 74.7% male (n=174) and 25.3% female (n=59). Yeast were isolated in 63 cases (21,3%) being 49.2% male (n=31) and 50.8% female (n=32). Ages varied between 2 and 77 years in the filamentous fungi group and between 10 and 83 years in the yeast group. The most frequently etiologic agents found in the filamentous group were Fusarium sp (n=137; 58,8%), Aspergillus sp (n=28; 12,0%), and Penicillium sp (n=12; 5,2%); and in the yeast group, Candida sp (n=59; 93,7%). Regarding the keratitis, 95.1% had at least one associated factor. Ocular trauma was significantly associated with filamentous fungi keratitis (p=0,0002*); and previous surgeries (p=0,0002*), ocular (p=0,0002*) and systemic diseases (p=0,0002*) with yeast keratitis. The use of topic antibiotics showed association with filamentous fungi keratitis, in a lower statistic significance (p= 0,0224*). Conclusions: Laboratorial analysis showed predominance of filamentous fungi over the yeast, and keratitis was the main ocular infection observed. Fungal keratitis involved at least one associated factor in most of the cases.
Keywords: fungal disease • keratitis • clinical laboratory testing