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Microbial keratitis in children
T E Clinch1, F E Palmon, M J Robinson
1LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans.
Abstract:
In a five-year review, we identified 29 cases of microbial infection in 28 patients who were 16 years old or younger. Herpes simplex infections were excluded. Predisposing factors included trauma (ten cases, 34%), severe systemic illness (eight cases, 27%), contact lens use (seven cases, 24%), exposure keratopathy (seven cases, 24%), and previous ocular surgery (six cases, 21%). A total of 24 microorganisms were identified in cultures of corneal scrapings from 22 of the 29 cases; two cases involved polymicrobial infections. Of the 24 identified pathogens, gram-positive cocci were the most common (12). Other microorganisms included gram-negative bacteria (five) and fungi (four). Isolated cases of Acanthamoeba species, Borrelia burgdorferi, and Bacillus species were also present. Therapy with intensive topical antibiotics was successful in this series. The rate of surgical intervention (6/29, 21%) was similar to that of previous reports.
Insights
Microbial eye infections in children under 16 are uncommon but linked to trauma, illness, and contact lens wear. Intensive antibiotic therapy proved effective, with surgery rates comparable to prior studies.
Area of Science:
- Ophthalmology
- Microbiology
- Pediatrics
Background:
- Microbial keratitis in pediatric patients is a significant concern.
- Understanding predisposing factors and common pathogens is crucial for effective management.
Purpose of the Study:
- To review cases of microbial eye infections in patients aged 16 years or younger over a five-year period.
- To identify predisposing factors, causative microorganisms, and treatment outcomes.
Main Methods:
- Retrospective review of 29 cases of microbial eye infections in patients aged 16 or younger.
- Exclusion of herpes simplex infections.
- Analysis of predisposing factors, microbial cultures, and treatment interventions.
Main Results:
- Twenty-nine cases were identified, with trauma, systemic illness, contact lens use, exposure keratopathy, and prior ocular surgery as key predisposing factors.
- Gram-positive cocci were the most common pathogens, followed by gram-negative bacteria and fungi.
- Intensive topical antibiotic therapy was successful in most cases, with a 21% surgical intervention rate.
Conclusions:
- Microbial keratitis in pediatric patients often results from specific predisposing conditions.
- Prompt and intensive antibiotic treatment is effective, minimizing the need for surgery.
- Continued vigilance for microbial eye infections in this age group is warranted.