Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011–2013)

Aruljyothi, Lokeshwari; Radhakrishnan, Nita; Prajna, Venkatesh; Lalitha, Prajna

doi:10.1136/bjophthalmol-2015-307631

Cited by 23 publications

(25 citation statements)

References 10 publications

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“…The most common risk factor associated with pediatric microbial keratitis in this cohort was trauma (57.0%), consistent with other studies from Mexico, India, and Saudi Arabia (4,10,11) whereas in Taiwan (9), the major risk factor was reported to be the contact lens wear (40.7%); this is in accordance with the above speculation for higher mean age of patients in this country. Trauma was mostly caused by organic materials (14,15) yet there were also cases caused by intimate objects, such as rocks, sand, soil, and fingernail, especially in younger children.…”

Section: Discussionsupporting

confidence: 92%

Pediatric Microbial Keratitis: A Tertiary Care Center Report

2018

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Background: Microbial keratitis in children can cause visual loss and amblyopia. In this study, epidemiological features of microbial keratitis in children was examined at a tertiary care center in Iran. Methods: Sixty-three cases of microbial keratitis under the age of 15 admitted at Khalili hospital, Shiraz, Iran, during five years, were reviewed. Patients' age, gender, residential area, ulcer size, causative organism, surgical, and medical treatment were investigated. Results: Mean age of patients was 5.2 ± 4.8 years and 68.2% were under five years old. The prevalence of microbial keratitis was significantly higher in males than females (P = 0.003), especially in children coming from rural areas. Ulcers larger than 5 mm were observed more than smaller ones (P ≤ 0.0001) in hospitalized children. Ocular trauma was the most common risk factor (present in 56.9%), while in 22.4%, no risk factor was detected. The most causative microbial agent was Staphylococcus (42.8%). Fungus was detected in two cases and herpes simplex was suspected in eight cases. In 54% recovery was observed with medical therapy; mainly by combination of cefazolin-gentamicin and ceftazidime-vancomycin drops. Penetrating keratoplasty was needed in 16.9% and conjunctival flap in 14.7% of recalcitrant cases. Overall recovery from microbial keratitis was observed in 72% of cases, who showed complete healing of ulcer or significant decrease in size at the time of discharge from the hospital. Conclusions: Pediatric microbial keratitis was more common under the age of five years old and trauma was the main predisposing factor. Staphylococcus was the main causative microorganism and recovery was observed with topical treatment in the majority of cases. Trauma prevention and timely treatment is recommended.

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Section: Discussionsupporting

confidence: 92%

Pediatric Microbial Keratitis: A Tertiary Care Center Report

2018

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“…All patients, regardless of their ability to pay, were examined by a corneal specialist and underwent scraping and corneal cultures per institutional protocol. [10] Every patient was prescribed appropriate treatment, as determined by the treating physician based on clinical diagnosis and microbiological studies. [10] The patients were advised to undergo TPK if they had a full thickness corneal perforation, were determined to have an impending perforation, had involvement near the corneal limbus, or progressed clinically despite appropriate medical therapy.…”

Section: Methodsmentioning

confidence: 99%

Demographic and socioeconomic barriers and treatment seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty

Shah

Radhakrishnan

Ramsewak

et al. 2019

Indian J Ophthalmol

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Purpose:To understand demographic and socioeconomic barriers and treatment-seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty (TPK) in a developing country.Methods:This prospective non-comparative questionnaire- based study included all patients presenting to Aravind Eye Hospital, Madurai with infectious keratitis that eventuated to TPK between November 2015 and October 2016. A structured questionnaire was administered on post-operative day 3 to collect data on the demographic details, predisposing factors, prior treatment received, and treatment expenditures.Results:In total, 227 patients underwent TPK between November 2015 and October 2016 for infectious keratitis. The majority of patients were males (n = 132, 58.1%), illiterate (n = 129, 56.8%), and had a family monthly income of less than INR 6000 (n = 142, 62.5%). Most of the patients (n = 163, 71.8%) had prior treatment with an ophthalmologist before presenting to our hospital. The mean distance travelled to reach our centre was 269.2 ± 298.5 km. The mean duration of disease before the presentation was 20.3 ± 21.1 days. Corneal smear was positive for fungus in 163 (88.1%) and Aspergillus was the most commonly isolated fungi in 55 (41.3%) cultures. The mean total cost of treatment was INR 8752.87 ± 7615.39 per patient. There was a positive correlation between the duration of the disease (rho 0.19, P = 0.0034) and the costs of treatment (rho 0.2, P = 0.0024) with the distance travelled by the patient.Conclusion:Patients who travelled a farther distance had a delayed onset of presentation and spent significantly more than their respective counterparts.

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“…Our study was a retrospective study with the plan being to estimate the risk factors, microbiological profile, and clinical outcomes of infectious keratitis affecting pediatric population. [ 5 ] This study included 240 eyes of 234 children. The cultures were positive in 142 (74.3%) eyes.…”

Section: Fungal Keratitis Is a Big Public Health Problemmentioning

confidence: 99%

Fungal keratitis: The Aravind experience

Prajna

Lalitha

Srinivasan

2017

Indian J Ophthalmol

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Research becomes very significant and meaningful when it addresses a significant public health problem of a region. Fungal keratitis is a serious problem affecting the agrarian poor and hence requires attention from public health specialists. The approach to a public health issue should focus not only on treatment but also prevention or at least show a significant thrust to reduce the morbidity of the problem. At our institution, we have developed a special interest in fungal keratitis and tried to study it in a multitude of aspects. As we put the pieces of the puzzle together, we believe that interest will be rekindled among policymakers, clinicians, microbiologists, pharmaceutical industry, and basic scientists to work together to join forces and take up an integrative approach to managing this problem. It is also believed that the article underscores the need and importance of having a focused approach to ensuring a successful career in clinical research.

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Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011–2013)

Cited by 23 publications

References 10 publications

Pediatric Microbial Keratitis: A Tertiary Care Center Report

Pediatric Microbial Keratitis: A Tertiary Care Center Report

Demographic and socioeconomic barriers and treatment seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty

Fungal keratitis: The Aravind experience

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