Jeena Mascarenhas1, Prajna Lalitha2, N Venkatesh Prajna1, Muthiah Srinivasan1, Manoranjan Das1, Sean S D'Silva1, Catherine E Oldenburg3, Durga S Borkar3, Elizabeth J Esterberg3, Thomas M Lietman4, Jeremy D Keenan5. 1. Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India. 2. Department of Ocular Microbiology, Aravind Eye Care System, Madurai, India. 3. Francis I. Proctor Foundation, University of California, San Francisco, California. 4. Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California; Department of Epidemiology & Biostatistics, University of California, San Francisco, California. 5. Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California. Electronic address: jeremy.keenan@ucsf.edu.
Abstract
PURPOSE: To determine risk factors and clinical signs that may differentiate between bacterial, fungal, and acanthamoeba keratitis among patients presenting with presumed infectious keratitis. DESIGN: Hospital-based cross-sectional study. METHODS: We examined the medical records of 115 patients with laboratory-proven bacterial keratitis, 115 patients with laboratory-proven fungal keratitis, and 115 patients with laboratory-proven acanthamoeba keratitis seen at Aravind Eye Hospital, Madurai, India, from 2006-2011. Risk factors and clinical features of the 3 organisms were compared using multinomial logistic regression. RESULTS: Of 95 patients with bacterial keratitis, 103 patients with fungal keratitis, and 93 patients with acanthamoeba keratitis who had medical records available for review, 287 (99%) did not wear contact lenses. Differentiating features were more common for acanthamoeba keratitis than for bacterial or fungal keratitis. Compared to patients with bacterial or fungal keratitis, patients with acanthamoeba keratitis were more likely to be younger and to have a longer duration of symptoms, and to have a ring infiltrate or disease confined to the epithelium. CONCLUSIONS: Risk factors and clinical examination findings can be useful for differentiating acanthamoeba keratitis from bacterial and fungal keratitis.
PURPOSE: To determine risk factors and clinical signs that may differentiate between bacterial, fungal, and acanthamoeba keratitis among patients presenting with presumed infectious keratitis. DESIGN: Hospital-based cross-sectional study. METHODS: We examined the medical records of 115 patients with laboratory-proven bacterial keratitis, 115 patients with laboratory-proven fungal keratitis, and 115 patients with laboratory-proven acanthamoeba keratitis seen at Aravind Eye Hospital, Madurai, India, from 2006-2011. Risk factors and clinical features of the 3 organisms were compared using multinomial logistic regression. RESULTS: Of 95 patients with bacterial keratitis, 103 patients with fungal keratitis, and 93 patients with acanthamoeba keratitis who had medical records available for review, 287 (99%) did not wear contact lenses. Differentiating features were more common for acanthamoeba keratitis than for bacterial or fungal keratitis. Compared to patients with bacterial or fungal keratitis, patients with acanthamoeba keratitis were more likely to be younger and to have a longer duration of symptoms, and to have a ring infiltrate or disease confined to the epithelium. CONCLUSIONS: Risk factors and clinical examination findings can be useful for differentiating acanthamoeba keratitis from bacterial and fungal keratitis.
Authors: Cyril Dalmon; Travis C Porco; Thomas M Lietman; N Venkatesh Prajna; Lalitha Prajna; Mano Ranjan Das; J Arun Kumar; Jeena Mascarenhas; Todd P Margolis; John P Whitcher; Bennie H Jeng; Jeremy D Keenan; Matilda F Chan; Stephen D McLeod; Nisha R Acharya Journal: Invest Ophthalmol Vis Sci Date: 2012-04-02 Impact factor: 4.799
Authors: M B Moore; J P McCulley; M Luckenbach; H Gelender; C Newton; M B McDonald; G S Visvesvara Journal: Am J Ophthalmol Date: 1985-09-15 Impact factor: 5.258