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Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011-2013).
Br J Ophthalmol 2016; 100(12):1719-1723BJ

Abstract

PURPOSE

To study the risk factors, microbiological profile and clinical outcomes of infectious keratitis affecting paediatric patients.

STUDY DESIGN

Retrospective case series.

METHODS

Review of case records of paediatric patients (0-16 years) diagnosed with infectious keratitis who presented to Aravind Eye Hospital, Madurai, India during January 2011 to December 2013. Demographic details, predisposing factors, microbiological investigations, clinical course and visual outcome were analysed.

RESULTS

In this time period, 240 eyes of 234 children had a diagnosis of infectious keratitis. One hundred and twenty-five (53.4%) children had a history of trauma. Smears were obtained in 220 eyes, while culture was performed in 191 eyes. The culture results were positive in 142 (74.3%) eyes. Fungi was the most common infectious agent isolated in culture (54.2%) followed by bacteria (40.8%) and acanthamoeba (2.1%). Successful healing of the keratitis with appropriate medical therapy occurred in 223 (92.9%) eyes, while 17 (7.1%) eyes required therapeutic keratoplasty. Of the 151 patients with preliminary and final visual acuity, vision improved by 2 lines in 68 eyes (45%), stayed the same in 75 eyes (49.6%) and worsened in 8 eyes (5.3%).

CONCLUSIONS

Contrary to previous reports, fungi are the most common aetiological organism in the causation of infectious keratitis in children in our study population. Fusarium was the most common fungal species isolated. These data are similar to the data obtained from adult patients with infectious keratitis in this region. While microbiological investigations are important to initiate appropriate antimicrobial therapy, the findings from our study need to be kept in mind, especially while initiating empirical therapy in this population.

Authors+Show Affiliations

Department of Cornea and Refractive Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India.Department of Cornea and Refractive Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India.Department of Cornea and Refractive Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India.Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, Tamil Nadu, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26917675

Citation

Aruljyothi, Lokeshwari, et al. "Clinical and Microbiological Study of Paediatric Infectious Keratitis in South India: a 3-year Study (2011-2013)." The British Journal of Ophthalmology, vol. 100, no. 12, 2016, pp. 1719-1723.
Aruljyothi L, Radhakrishnan N, Prajna VN, et al. Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011-2013). Br J Ophthalmol. 2016;100(12):1719-1723.
Aruljyothi, L., Radhakrishnan, N., Prajna, V. N., & Lalitha, P. (2016). Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011-2013). The British Journal of Ophthalmology, 100(12), pp. 1719-1723. doi:10.1136/bjophthalmol-2015-307631.
Aruljyothi L, et al. Clinical and Microbiological Study of Paediatric Infectious Keratitis in South India: a 3-year Study (2011-2013). Br J Ophthalmol. 2016;100(12):1719-1723. PubMed PMID: 26917675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011-2013). AU - Aruljyothi,Lokeshwari, AU - Radhakrishnan,Naveen, AU - Prajna,Venkatesh N, AU - Lalitha,Prajna, Y1 - 2016/02/25/ PY - 2015/08/10/received PY - 2015/12/12/revised PY - 2016/02/07/accepted PY - 2016/2/27/pubmed PY - 2017/6/7/medline PY - 2016/2/27/entrez KW - Cornea KW - Infection SP - 1719 EP - 1723 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 100 IS - 12 N2 - PURPOSE: To study the risk factors, microbiological profile and clinical outcomes of infectious keratitis affecting paediatric patients. STUDY DESIGN: Retrospective case series. METHODS: Review of case records of paediatric patients (0-16 years) diagnosed with infectious keratitis who presented to Aravind Eye Hospital, Madurai, India during January 2011 to December 2013. Demographic details, predisposing factors, microbiological investigations, clinical course and visual outcome were analysed. RESULTS: In this time period, 240 eyes of 234 children had a diagnosis of infectious keratitis. One hundred and twenty-five (53.4%) children had a history of trauma. Smears were obtained in 220 eyes, while culture was performed in 191 eyes. The culture results were positive in 142 (74.3%) eyes. Fungi was the most common infectious agent isolated in culture (54.2%) followed by bacteria (40.8%) and acanthamoeba (2.1%). Successful healing of the keratitis with appropriate medical therapy occurred in 223 (92.9%) eyes, while 17 (7.1%) eyes required therapeutic keratoplasty. Of the 151 patients with preliminary and final visual acuity, vision improved by 2 lines in 68 eyes (45%), stayed the same in 75 eyes (49.6%) and worsened in 8 eyes (5.3%). CONCLUSIONS: Contrary to previous reports, fungi are the most common aetiological organism in the causation of infectious keratitis in children in our study population. Fusarium was the most common fungal species isolated. These data are similar to the data obtained from adult patients with infectious keratitis in this region. While microbiological investigations are important to initiate appropriate antimicrobial therapy, the findings from our study need to be kept in mind, especially while initiating empirical therapy in this population. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/26917675/Clinical_and_microbiological_study_of_paediatric_infectious_keratitis_in_South_India:_a_3_year_study__2011_2013__ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&pmid=26917675 DB - PRIME DP - Unbound Medicine ER -