Related Experiment Video
Updated: Mar 6, 2026
A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
Paediatric infectious keratitis: a case series of 107 children presenting to a tertiary referral centre
Julia Dutra Rossetto1,2, Kara M Cavuoto1, Carla J Osigian1
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Insights
Contact lens wear is the leading cause of pediatric microbial keratitis in South Florida. Pseudomonas aeruginosa was the most common pathogen, and most cases improved with antibiotic treatment.
Area of Science:
- Ophthalmology
- Microbiology
- Pediatrics
Background:
- Corneal ulcers can cause severe vision loss in children.
- Recent trends in pediatric microbial ulcerative keratitis in the USA are not well-documented.
Purpose of the Study:
- To analyze risk factors, microbiological profiles, and treatment outcomes of pediatric microbial keratitis in South Florida.
Main Methods:
- Retrospective case series of 107 pediatric patients (<18 years) diagnosed with microbial ulcerative keratitis from 1992-2015.
- Data collected included demographics, culture results, microbial susceptibility, management, and outcomes.
- Analysis of 107 pediatric patients with microbial ulcerative keratitis.
Main Results:
- Contact lens wear (77.6%) was the primary risk factor, followed by ocular trauma (8.4%).
- Pseudomonas aeruginosa (46.2%) was the predominant organism, followed by Stenotrophomonas maltophilia (19.2%) and Fusarium (13.5%).
- Visual acuity improved significantly from 20/160 to 20/50 (p<0.0001) with medical management, and no therapeutic penetrating keratoplasty was required.
Conclusions:
- Contact lens wear is the most frequent risk factor for infectious keratitis in pediatric patients.
- Pseudomonas aeruginosa is the most common microorganism identified in this South Florida population.
- Most pediatric microbial keratitis cases respond favorably to medical management.
Background/Aims:
Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida.
Methods:
A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed. Patient demographics, culture data, microbial susceptibility, management trends and patient outcomes were collected.
Results:
Mean age of patients was 13±4.6 years (range 0.2-17 years). The most common associated risk factor was contact lens wear (77.6%), followed by ocular trauma (8.4%). Systemic factors were present in 4.7% of cases. Cultures were taken from 89 patients. A total of 74 organisms were isolated from the 52 corneal scrapings with growth, yielding a 58.4% positivity rate. Seventeen microbial species were identified, with a predominance of Pseudomonas aeruginosa (46.2%), followed by Stenotrophomonas maltophilia (19.2%) and Fusarium (13.5%). Combined fortified antibiotics were the most common treatment (51.4%). Mean follow-up time was 40.6±91.6 weeks (range: 0.3-480 weeks). The mean visual acuity improved from 20/160 to 20/50 (p<0.0001). No therapeutic penetrating keratoplasty was needed.
Conclusions:
In this study, contact lens wear was the most frequent risk factor in infectious keratitis in children. P. aeruginosa was the most common microorganism present in our setting. The majority of the cases responded well to medical management.
