Pediatric Microbial Keratitis in Taiwanese Children

Hsiao, Ching-Hsi; Yeung, Ling; David, H. K.; Chen, Yeong-Fong; Lin, Hsin-Chiung; Tan, Hsin-Yuan; Huang, Song‐Chei; Lin, Ken‐Kuo

doi:10.1001/archopht.125.5.603

Cited by 83 publications

(87 citation statements)

References 24 publications

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“…Previous studies showed that 11.8-39.3% of childhood microbial keratitis, not just bacterial infection, had a visual outcome of worse than 6/60. 2,7,8,24 Variations in the reported visual impairment rate may be because of the inclusion of patients with different severity and different pathogen. Relationships between the presence of visual impairment and clinical characteristics of paediatric patients were also explored in the present study, and Gram-negative bacterial infection and the increasing number of resistant antibiotics were found to be independent risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…So far, only a few studies from the United States, India, and Taiwan have demonstrated its characteristics, 1,[4][5][6][7][8] with predisposing factors reported to be contact lens wear, trauma, ocular disease, systemic disease, and environmental factors. 2,9,10 The purpose of this study was to review the microbiological profile and in vitro antibiotic susceptibility of paediatric bacterial keratitis diagnosed by our institution, and to explore their relationships with visual outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Hong

Chen

Sun

et al. 2012

Eye

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Purpose The purpose of this study was to review the microbiological profile, in vitro antibiotic susceptibility and visual outcomes of paediatric microbial keratitis in Shanghai, China over the past 6 years. Methods Medical records of patients aged r16 years were reviewed, who were diagnosed as having bacterial keratitis between 1 January 2005 and 31 December 2010. Bacterial culture results and in vitro antibiotic susceptibility were analysed. A logistic regression analysis was conducted to evaluate the relationship between visual impairment and possible risk factors. Results Eighty consecutive cases of paediatric bacterial keratitis cases were included, among which 59 were identified as having positive culture. Staphylococcus epidermidis was the most commonly isolated organism (n ¼ 23; 39.0%), followed by Streptococcus pneumoniae (n ¼ 11; 18.6%) and Pseudomonas aeruginosa (n ¼ 6; 10.2%). Antibiotic sensitivities revealed that tested bacteria had low resistance rates to fluoroquinolones and aminoglycosides (8.3-18.4% and 12.5-24.4%, respectively). Multivariate logistic regression analysis proved that visual impairment was significantly associated with Gram-negative bacterial infection (odds ratio (OR) ¼ 7.626; P ¼ 0.043) and an increasing number of resistant antibiotics (OR ¼ 0.385; P ¼ 0.040). Conclusions S. epidermidis was the most common isolated organism in Shanghai paediatric keratitis. The fluoroquinolones and aminoglycosides remained good choices for treating these patients. Gram-negative bacterial infection and an increasing number of resistant antibiotics were associated with worse visual prognoses in paediatric keratitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Hong

Chen

Sun

et al. 2012

Eye

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“…18 In one of the largest pediatric specific series of microbial keratitis, only 2 patients out of 78 presented with perforation. 30 Other techniques described to treat corneal perforations include LK or DLK, PKP with glycerin cryopreserved grafts and most recently crosslinking. 24,25,[31][32][33] All these have limited experience in children.…”

Section: Discussionmentioning

confidence: 99%

Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature

Medsinge

Gajdošová

Moore

et al. 2016

Eye

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Purpose To assess the outcome of early therapeutic penetrating keratoplasty (PKP) for corneal melt leading to perforation in children.Methods Case notes of all the consecutive patients presenting with acute corneal perforation that underwent urgent therapeutic PKP between 2000 and 2010 to the practice of one of the authors, both NHS at Great Ormond Street Hospital for Children and private, were retrospectively reviewed. Onset of perforation, underlying cause, medical and surgical treatment, pre-and post-operative visual acuity, graft clarity, length of followup, and post-operative complications were recorded. Results Four eyes of four consecutive patients (mean age of 9.5 years and median 8.5 years, range 4-17 years) were treated for acquired acute onset corneal perforations. There were three females and one male.

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“…Other signs are redness of the eye, blepharitis lid edema, satellite lesions, increasing eye pain, or discomfort or foreign body sensation, increased light sensitivity, raised slough, dry eyes, abnormalities and conjunctival congestion, corneal degeneration, and defective vision (4). In children, corneal ulcers, as defined by the corneal infiltrate, hypopyon, and perforations were reported with no significant difference between age groups (16). If 1 or 3 clinical features (raised slough, dry eyes, abnormalities, conjunctival congestion, corneal degeneration and defective vision pain, serrated margins, raised slough, hypopyon, redness of the eye, blepharitis lid edema, and fibrinous exudates) were present, the probabilities of FK would have been 63% and 83%, respectively (22).The most infected site is cornea (23).…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…If 1 or 3 clinical features (raised slough, dry eyes, abnormalities, conjunctival congestion, corneal degeneration and defective vision pain, serrated margins, raised slough, hypopyon, redness of the eye, blepharitis lid edema, and fibrinous exudates) were present, the probabilities of FK would have been 63% and 83%, respectively (22).The most infected site is cornea (23). Infection was reported the most with male preponderance, with a male-to-female ratio of 147/234, 62.8% (3), but there was a report indicating no significant difference in sex (16). Infection frequently occurs in males in agricultural activities, especially during summer, and if children do not use any protection for the eyes, they become infected by the plant debris, leaf spots, vegetative garbage, seedling blight, and seed germination.…”

Section: Signs and Symptomsmentioning

confidence: 99%

Management of Fungal Keratitis in Pediatric Patients

Badiee

Nejabat

Choopanizadeh

2017

Arch Pediatr Infect Dis

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Context: Fungal keratitis is an uncommon infection with high morbidity in pediatric patients. Trauma is the most common risk factor for infection in children. Thus, rapid diagnosis should be made by scoring clinical features and mycological examination. This review discusses the management of fungal keratitis in pediatric patients. Evidence Acquisition: In this narrative review, the most recently published data on pediatric fungal keratitis, respective prominent signs and symptoms, etiologic agents, diagnosis and treatment of this infection have been reviewed. Results: Laboratory methods such as investigation of smear by potassium hydroxide and staining and cultural and molecular methods can be helpful in the diagnosis. Treatment of this infection with improved outcome is challenging. Medical therapy (topical and systemic treatments) is the first choice of treatment, but early surgical intervention and removal of the infected tissues are critical for effective cure. Lack of response to these therapies requires corneal transplantation. Unfortunately, loss of useful vision rate was found in patients even with treatment by antifungal agents. Conclusions:The signs and symptoms of fungal keratitis are similar to those of other microbial keratitis. Use of diagnostic methods and early treatment are helpful for recovery in infected pediatric patients.

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Pediatric Microbial Keratitis in Taiwanese Children

Cited by 83 publications

References 24 publications

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature

Management of Fungal Keratitis in Pediatric Patients

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