Tags

Type your tag names separated by a space and hit enter

Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi.
Br J Ophthalmol 2005; 89(12):1554-8BJ

Abstract

AIM

To assess whether the presence of characteristic clinical features can be used as a diagnostic aid for suppurative keratitis caused by filamentous fungi.

METHODS

Patients presenting with suppurative keratitis in India underwent detailed clinical examination followed by microbiological investigation of corneal scrapes. A partial diagnostic score based upon the strength of the association, as estimated by the odds ratio, between reported clinical features and laboratory confirmed diagnoses was devised and subsequently tested using a case series from Ghana.

RESULTS

Serrated margins, raised slough, dry texture, satellite lesions and coloration other than yellow occurred more frequently in cases of filamentous fungal keratitis than bacterial keratitis (p<0.05). Hypopyon and fibrinous exudate were observed more frequently in bacterial keratitis (p<0.05). When incorporated into a backwards stepwise logisitic regression model only serrated margins, raised slough, and colour were independently associated with fungal keratitis; these features were used in the scoring system. The probability of fungal infection if one clinical feature was present was 63%, increasing to 83% if all three features were present.

CONCLUSIONS

Microbiological investigations should be performed whenever possible; however, where facilities are not available, a rapid presumptive diagnosis of suppurative keratitis may be possible by scoring clinical features.

Authors+Show Affiliations

Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

16299128

Citation

Thomas, P A., et al. "Characteristic Clinical Features as an Aid to the Diagnosis of Suppurative Keratitis Caused By Filamentous Fungi." The British Journal of Ophthalmology, vol. 89, no. 12, 2005, pp. 1554-8.
Thomas PA, Leck AK, Myatt M. Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi. Br J Ophthalmol. 2005;89(12):1554-8.
Thomas, P. A., Leck, A. K., & Myatt, M. (2005). Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi. The British Journal of Ophthalmology, 89(12), pp. 1554-8.
Thomas PA, Leck AK, Myatt M. Characteristic Clinical Features as an Aid to the Diagnosis of Suppurative Keratitis Caused By Filamentous Fungi. Br J Ophthalmol. 2005;89(12):1554-8. PubMed PMID: 16299128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi. AU - Thomas,P A, AU - Leck,A K, AU - Myatt,M, PY - 2005/11/22/pubmed PY - 2006/2/4/medline PY - 2005/11/22/entrez SP - 1554 EP - 8 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 89 IS - 12 N2 - AIM: To assess whether the presence of characteristic clinical features can be used as a diagnostic aid for suppurative keratitis caused by filamentous fungi. METHODS: Patients presenting with suppurative keratitis in India underwent detailed clinical examination followed by microbiological investigation of corneal scrapes. A partial diagnostic score based upon the strength of the association, as estimated by the odds ratio, between reported clinical features and laboratory confirmed diagnoses was devised and subsequently tested using a case series from Ghana. RESULTS: Serrated margins, raised slough, dry texture, satellite lesions and coloration other than yellow occurred more frequently in cases of filamentous fungal keratitis than bacterial keratitis (p<0.05). Hypopyon and fibrinous exudate were observed more frequently in bacterial keratitis (p<0.05). When incorporated into a backwards stepwise logisitic regression model only serrated margins, raised slough, and colour were independently associated with fungal keratitis; these features were used in the scoring system. The probability of fungal infection if one clinical feature was present was 63%, increasing to 83% if all three features were present. CONCLUSIONS: Microbiological investigations should be performed whenever possible; however, where facilities are not available, a rapid presumptive diagnosis of suppurative keratitis may be possible by scoring clinical features. SN - 0007-1161 UR - https://www.unboundmedicine.com/medline/citation/16299128/Characteristic_clinical_features_as_an_aid_to_the_diagnosis_of_suppurative_keratitis_caused_by_filamentous_fungi_ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&amp;pmid=16299128 DB - PRIME DP - Unbound Medicine ER -