Journal of Medical and Surgical
Research (JMSR)


Pages: 570-575

Date of Publication: 30-Nov--0001

Fungal Keratitis: a Study from a Moroccan Center

Author: Kawtar Belkhadir, Maryam Elikhloufi, Ihsane Sabrane, Abdellah Amazouzi, Ouafaa Cherkaoui

Category: JMSR Ophtalmology

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Context: Fungal keratitis is a serious condition, occurring most often on fragile corneas. In Morocco, we do not always have an optimal technical platform for the diagnosis of these pathologies, nor for therapeutic means, both pharmaceutical and surgical for their management.

Aim: The aim of our study was to study the specificities of the epidemiology, diagnosis, treatment and prognosis of fungal keratitis in our Moroccan background.

Methods and Material: We reviewed all fungal keratitis cases between October 2014 and October 2016 in ophthalmology department A in Ibn Sina Hospital in Rabat.

Results: We reviewed 27 patients hospitalized for fungal keratitis. Ocular trauma and local corticosteroid therapy were found in 37% and 44.4% of patients respectively. The mean time between the first clinical signs and the emergency department consultation was 21 days, and 66.7% of the patients were referred for non-improvement with antibiotic eye drops. The initial visual acuity ranged from 2/10th to no luminous perception. All patients received corneal scratching upon admission for diagnostic and therapeutic use. It confirmed the clinical suspicion of fungal keratitis in 51.9% of the cases. The evolution was marked by the occurrence of corneal perforation in 37% of patients, the persistence of a corneal opacity in 88.9% of the cases. An improvement in visual acuity was observed in 12 of our patients.

Conclusion: Fungal keratitis represent severe infections. In Morocco, like in many others countries, we have to adapt our diagnosis and therapeutic protocols according to our conditions. The mycological data are still insufficient, and most often confirm a strong clinical presumption. The prognosis is conditioned by an early diagnosis and the rapid initiation of an effective treatment.

Keywords: Fungal keratitis, Cornea, Ocular surface diseases, Voriconazole, Fluconazole


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