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A five-year report of pediatric non-viral microbial keratitis in a tertiary eye center
Muhammed Dara Tas1, Melis Palamar1, Sabire Sohret Aydemir2
1Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova-Izmir, Turkey.
Purpose:
To evaluate the demographic data, risk factors, clinical outcomes, microbial spectrum, and treatment in pediatric microbial keratitis cases.
Methods:
The medical data including demographics, predisposing factors, accompanying diseases, clinical course, and microbial culture results was retrospectively evaluated. A total of 27 patients younger than 18 years who were diagnosed as microbial keratitis in a tertiary referral center between March 2019 and December 2023 were included in the study.
Results:
The male/female ratio was 14/13. The mean age was 13.02 ± 6.21 (range, 2-18) years. The most common risk factor was contact lens use (33.8%) followed by trauma (18.5%). The most common accompanied disease was acne rosacea (7.4%). In 20 cases (with a lesion greater than 2 mm in diameter, involving a layer deeper than half of the cornea, etc.) culture samples were taken. Cultures were positive for microbial growth in 8 (40.0%) patients and Pseudomonas aeruginosa was the most frequently isolated organism (25.0%). While 24 (88.8%) of the keratitis improved with medical treatment alone, additional corneal debridement was applied to 2 (7.4%) eyes, and therapeutic penetrating keratoplasty was performed in one refractory case.
Conclusion:
Although rarer than adult cases, pediatric keratitis is an important entity in childhood due to difficulties and complications in history taking, examination and medication use. This study emphasizes the role of contact lens usage and trauma as the primary causes and Pseudomonas aeruginosa as the most frequent microorganism in pediatric keratitis. Identification of predisposing factors and microorganisms may be helpful for early recognition and treatment.
Insights
Pediatric microbial keratitis, though less common than in adults, is significant in children. Contact lens use and trauma are key causes, with Pseudomonas aeruginosa being the most frequent pathogen.
Area of Science:
- Ophthalmology
- Microbiology
- Pediatrics
Background:
- Pediatric microbial keratitis presents unique challenges in diagnosis and management.
- Understanding causative agents and risk factors is crucial for effective treatment.
Purpose of the Study:
- To analyze demographic data, risk factors, clinical outcomes, microbial spectrum, and treatment strategies for pediatric microbial keratitis.
- To identify key predisposing factors and common microorganisms in childhood microbial keratitis.
Main Methods:
- Retrospective evaluation of medical data from 27 pediatric patients (under 18 years) diagnosed with microbial keratitis.
- Analysis included demographics, predisposing factors, clinical course, and microbial culture results from March 2019 to December 2023.
Main Results:
- Contact lens use (33.8%) and trauma (18.5%) were the most common risk factors.
- Pseudomonas aeruginosa was the most frequent isolate (25.0%) in positive cultures (40.0% of samples).
- Most cases (88.8%) resolved with medical treatment, with some requiring surgical intervention.
Conclusions:
- Pediatric microbial keratitis requires careful attention due to diagnostic and treatment complexities.
- Contact lens wear and trauma are significant risk factors, and Pseudomonas aeruginosa is a primary pathogen.
- Early identification of risk factors and pathogens aids in prompt recognition and management of pediatric microbial keratitis.
