SUPPURATIVE CORNEAL ULCERATION IN BANGLADESH - A STUDY OF 142 CASES EXAMINING THE MICROBIOLOGICAL DIAGNOSIS, CLINICAL AND EPIDEMIOLOGIC FEATURES OF BACTERIAL AND FUNGAL KERATITIS

Suppurative keratitis is an important preventable cause of blindness, particularly in the developing world. This study analyses 142 cases of suppurative keratitis referred to Chittagong Eye Infirmary, Banglades h, Some 53.5% of cases were bacterial and 35.9% were fungal. The five most common pathogens were: Pseudomonas sp. 24%, Streptococcus pneumon iae 17%, Aspergillus sp. 13%, Fusarium sp. 7% and Curvularia sp. 6%. G ram stain and culture results were consistent in 62.6% of cases. Previ ous antibiotic treatment was a significant factor for failure of cultu re isolation and less so for Gram stain failure. On Gram stain, 55.9% of pseudomonal cases were missed, but only 2% of fungal cases were mis sed. Over all, Gram stain had a sensitivity of 62% and positive predic tive value of 84% for bacterial cases, and 98% and 94% for fungal case s, respectively. Fungal ulcers were typically filamentous, but an ante cedent history of trauma was not common. The most frequent injury was due to rice grains, but the inoculum appeared to be introduced during eye washing with contaminated water. Pseudomonal ulcers occurred most frequently in the monsoon season, and Fusarium cases were seen only in the hot, dry season.