Clinical and microbiological profile of infectious keratitis in children
PURPOSE To study the predisposing factors, clinical and microbiologic characteristics, treatment, and outcomes of pediatric microbial keratitis. METHODS The medical records of 80 eyes with (nonviral) microbial keratitis in 76 children aged 16 years or younger were retrospectively reviewed. Demographic features, predisposing factors, clinical features, etiologic microorganisms, and treatment outcomes were analyzed. RESULTS Seventy-six patients met the inclusion criteria of this study, and the male to female ratio was 1.9:1. The average age of the children was 8.9 ± 5.7 years, and the mean duration of symptoms was 12.5 ± 9.8 days. The most common predisposing factor was trauma (58.8%). Thirty-nine (48.8%) of 80 cases were culture positive. Bacterial isolates were observed in 21 cases, being headed by coagulase-negative Staphylococcus, and fungi were found in 19 cases, with Fusarium sp. the predominant pathogen. Fifty-nine cases required surgery intervention. Fifty of the 58 examined eyes achieved best-corrected visual acuity of 20/200 or better at the final follow-up. CONCLUSIONS The most common risk factor for childhood microbial keratitis was corneal trauma. The most frequent bacteria isolated were coagulase-negative Staphylococcus, whereas the predominant fungi isolated were Fusarium species. Early diagnosis, intensive drug therapy, and timely surgical intervention may effectively improve the prognosis of pediatric microbial keratitis.