Mycotic keratitis in children: epidemiologic and microbiologic evaluation.Cornea. 1997 May; 16(3):295-9.C
To evaluate the demographic features, clinical profile, and laboratory diagnosis in cases of mycotic keratitis in children.
We retrospectively analyzed 211 cases of mycotic keratitis in children younger than 16 years over a 5-year period in a tertiary eye center. Culture-proven cases of fungal keratitis were reviewed.
Trauma was the most common predisposing factor (55.3%), followed by associated systemic illness (11.2%), previous ocular surgery (9.8%), and others. Corneal injury contaminated with vegetable matter was responsible for 60.5% of traumatic cases. Aspergillus species were the most frequent isolates (39.5%). Others included Fusarium (10.7%), Alternaria (10.2%), Curvularia (7.4%), and Penicillium (7%). A seasonal variation in the incidence of mycotic keratitis revealed a peak incidence in the months of September and October. One hundred sixty-two children (76.7%) cooperated for examination and scraping under topical anesthesia with or without sedation. General anesthesia for scraping was required in 49 (23%) of 211 children for corneal scraping. Gram stains of corneal scraping were positive for hyphal elements in 54.5% of cases, and potassium hydroxide wet-mount preparation was positive in 90.2% of cases.
This study highlights important risk factors and organisms responsible for mycotic keratitis in children.