The diagnosis and management of keratomycoses. I. Cause and diagnosis.

Causative isolates, clinical features, and laboratory studies are reported for sixty-one cases of culture-proved mycotic keratitis. Isolates are categorized into four groups, including 36 Fusarium solani, 11 other Moniliaceae species, seven Dematiaceae, and seven yeasts. Of the 61 patients, 42 were men. Mild outdoor trauma was sustained in 14 of 24 cases. Patients were often referred with a clinical diagnosis of presumed fungal keratitis, within one week of symptom development, and usually had not received topically applied steroids prior to referral. Laboratory diagnosis necessitates prompt corneal scrapings, preferably stained with Giemsa or Gram, and culture on Sabouraud and blood agar maintained at room temperature, with growth usually evident by 48 hours.