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Published on: February 9, 2011
Pediatric microbial keratitis: a tertiary hospital study
Xiusheng Song1, Lingjuan Xu, Shiying Sun
1Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.
Purpose:
To study the predisposing factors, clinical and microbiologic characteristics, treatment, and outcomes of pediatric microbial keratitis.
Methods:
The medical records of 80 eyes with (nonviral) microbial keratitis in 76 children aged 16 years or younger were retrospectively reviewed. Demographic features, predisposing factors, clinical features, etiologic microorganisms, and treatment outcomes were analyzed.
Results:
Seventy-six patients met the inclusion criteria of this study, and the male to female ratio was 1.9:1. The average age of the children was 8.9 ± 5.7 years, and the mean duration of symptoms was 12.5 ± 9.8 days. The most common predisposing factor was trauma (58.8%). Thirty-nine (48.8%) of 80 cases were culture positive. Bacterial isolates were observed in 21 cases, being headed by coagulase-negative Staphylococcus, and fungi were found in 19 cases, with Fusarium sp. the predominant pathogen. Fifty-nine cases required surgery intervention. Fifty of the 58 examined eyes achieved best-corrected visual acuity of 20/200 or better at the final follow-up.
Conclusions:
The most common risk factor for childhood microbial keratitis was corneal trauma. The most frequent bacteria isolated were coagulase-negative Staphylococcus, whereas the predominant fungi isolated were Fusarium species. Early diagnosis, intensive drug therapy, and timely surgical intervention may effectively improve the prognosis of pediatric microbial keratitis.
Insights
Corneal trauma is the leading cause of pediatric microbial keratitis. Prompt treatment and surgery improve vision outcomes in affected children.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Microbial keratitis is a significant cause of vision loss in children.
- Understanding predisposing factors and causative agents is crucial for effective management.
Purpose of the Study:
- To investigate the factors contributing to pediatric microbial keratitis.
- To characterize clinical and microbiologic features, treatment strategies, and outcomes.
Main Methods:
- Retrospective review of medical records for 80 eyes in 76 children (≤16 years) with nonviral microbial keratitis.
- Analysis of demographic data, predisposing factors, clinical presentation, microbial isolates, and treatment outcomes.
Main Results:
- Corneal trauma was the most frequent predisposing factor (58.8%).
- Coagulase-negative Staphylococcus and Fusarium species were the predominant bacterial and fungal pathogens, respectively.
- Nearly 74% of cases (59/80) required surgical intervention, with 86% achieving good visual acuity (≥20/200).
Conclusions:
- Corneal trauma is a primary risk factor for microbial keratitis in children.
- Early diagnosis, aggressive medical treatment, and timely surgery are vital for favorable visual prognoses.
- Identifying common pathogens guides appropriate antimicrobial therapy.
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