Paediatric infectious keratitis: a case series of 107 children presenting to a tertiary referral centre

Paediatric infectious keratitis: a case series of 107 children presenting to a tertiary referral centre

Author Rossetto, Julia Dutra Autor UNIFESP Google Scholar
Cavuoto, Kara M. Google Scholar
Osigian, Carla J. Google Scholar
Chang, Ta Chen (Peter) Google Scholar
Miller, Darlene Google Scholar
Capo, Hilda Google Scholar
Spierer, Oriel Google Scholar
Abstract 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.
xmlui.dri2xhtml.METS-1.0.item-coverage London
Language English
Sponsor CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil
NIH Center Core Grant
Research to Prevent Blindness Unrestricted Grant
Grant number NIH Center Core Grant: P30EY014801
Date 2017
Published in British Journal Of Ophthalmology. London, v. 101, n. 11, p. 1488-1492, 2017.
ISSN 0007-1161 (Sherpa/Romeo, impact factor)
Publisher Bmj Publishing Group
Extent 1488-1492
Origin http://dx.doi.org/10.1136/bjophthalmol-2016-310119
Access rights Closed access
Type Article
Web of Science ID WOS:000413696100008
URI https://repositorio.unifesp.br/handle/11600/58285

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