Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
Department of Ocular Microbiology, Aravind Eye Care System, Madurai, India.
Am J Ophthalmol. 2014 Jan;157(1):56-62. doi: 10.1016/j.ajo.2013.08.032. Epub 2013 Nov 5.
To determine risk factors and clinical signs that may differentiate between bacterial, fungal, and acanthamoeba keratitis among patients presenting with presumed infectious keratitis.
Hospital-based cross-sectional study.
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.
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.
Risk factors and clinical examination findings can be useful for differentiating acanthamoeba keratitis from bacterial and fungal keratitis.
确定可能有助于区分细菌性、真菌性和棘阿米巴性角膜炎的危险因素和临床体征，这些角膜炎的患者均被初步诊断为感染性角膜炎。
医院横断面研究。
我们检查了印度 Madurai 的 Aravind 眼科医院在 2006 年至 2011 年间收治的 115 例实验室确诊的细菌性角膜炎患者、115 例实验室确诊的真菌性角膜炎患者和 115 例实验室确诊的棘阿米巴性角膜炎患者的病历。采用多项逻辑回归比较 3 种病原体的危险因素和临床特征。
在可查阅病历的 95 例细菌性角膜炎患者、103 例真菌性角膜炎患者和 93 例棘阿米巴性角膜炎患者中，有 287 例（99%）未佩戴隐形眼镜。棘阿米巴性角膜炎的鉴别特征比细菌性或真菌性角膜炎更常见。与细菌性或真菌性角膜炎患者相比，棘阿米巴性角膜炎患者更年轻，症状持续时间更长，且更可能出现环状浸润或病变局限于上皮。
危险因素和临床检查结果有助于区分棘阿米巴性角膜炎与细菌性和真菌性角膜炎。
