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Pediatric Fungal Keratitis: Predisposing Factors, Clinical Features, and Outcomes During a 24-Year Study

Ahyan Ilman Qudsi1, Zhenyu Wei1, Zijun Zhang1

  • 1Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Translational Vision Science & Technology
|January 14, 2026
PubMed

Insights

Pediatric fungal keratitis (FK) in North China is often caused by trauma, with Fusarium and Aspergillus as common culprits. Amphotericin B shows effectiveness, and early intervention is key for better outcomes in pediatric FK.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Pediatric fungal keratitis (FK) poses a significant threat to vision in children.
  • Understanding regional trends in causative fungi and their susceptibility is crucial for effective treatment.

Purpose of the Study:

  • To analyze the clinical characteristics, antifungal susceptibility, and treatment outcomes of pediatric FK.
  • To identify key risk factors and predictors of treatment duration in pediatric FK cases.

Main Methods:

  • Retrospective analysis of 88 pediatric FK cases from July 2000 to October 2023 at Beijing Tongren Hospital.
  • Data collected included demographics, predisposing factors, clinical signs, microbiological findings, treatment regimens, and patient outcomes.
  • Fungal identification was confirmed by culture or microscopy.

Main Results:

  • Trauma, particularly from toys and writing tools, was the leading predisposing factor (35.2%).
  • Common clinical features included dense infiltrates (100%), feathery margins (69.2%), and multifocal lesions (38.5%).
  • Fusarium (43.9%) and Aspergillus (25.8%) were the most common fungal isolates; Amphotericin B demonstrated in vitro and clinical efficacy.

Conclusions:

  • Fusarium and Aspergillus are predominant pathogens in North China's pediatric FK, with trauma as the primary risk factor.
  • Amphotericin B is an effective antifungal agent for pediatric FK.
  • Early diagnosis and prompt treatment are essential to improve visual outcomes and reduce treatment duration, with ocular surgery and toddler age being significant predictors.
Abstract

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