Immunization and nutritional profile of cases with atraumatic microbial keratitis in preschool age group.

PURPOSE: To evaluate the role of protein energy malnutrition and immunization profile in cases of atraumatic microbial keratitis in preschool children.
DESIGN: Retrospective case analysis.
METHODS: Case records of all children 5 years of age and younger with atraumatic microbial keratitis treated at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India, between January and December 2006 were reviewed retrospectively. Main parameters evaluated were age, degree of protein-energy malnutrition, immunization profile, microbiologic profile, and final outcome.
RESULTS: Fifty-four consecutive children were enrolled during the study period. The mean age was 33.69 ± 21.91 months (range, 3 to 60 months). Mean weight on presentation was 10.57 ± 3.87 kg (range, 4 to 17 kg), with an average protein-energy malnutrition grade of 1.77 ± 0.74. The immunization for age was complete in 43 (80%) children. Severe protein-energy malnutrition was associated with the occurrence of bilateral keratitis (P < .001) and incomplete immunization (P < .001). Positive bacterial culture results were obtained in 44 (82%) cases, with Staphylococcus species being the most prevalent isolate (33/44; 75%). Cases requiring emergency corneal transplantation (24%) were associated with severe protein-energy malnutrition (P < .00) and bilaterality (P < .00). In multivariate analyses, cases without severe protein-energy malnutrition were 36% less likely to undergo any kind of surgical intervention (odds ratio, 0.64; 95% confidence interval, 0.04 to 0.91).
CONCLUSIONS: Our study highlights the association of protein-energy malnutrition and immunization profile with the occurrence of atraumatic microbial keratitis in preschool children. Most of these cases required corneal transplantation surgery to preserve the ocular integrity and to restore vision.