Soleimani Mohammad, Baharnoori Seyed Mahbod, Ghafarian Sadegh, Atighehchian Mehrnaz, Cheraqpour Kasra, Tabatabaei Seyed Ali, Ghanbari Hamidreza, Soleimanzadeh Mahdi, Bijani Faezeh Moghimpour, Almasi Solmaz, Zeidabadinejad Haniyeh, Davarpanah Ali, Sajedi Marzieh, Sefidan Bahram Bohrani, Habeel Samer, Masoumi Ahmad, Zamani Mohammad Hossein, Djalilian Ali R
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
J Ophthalmic Inflamm Infect. 2024 Jul 15;14(1):33. doi: 10.1186/s12348-024-00414-0.
Infectious keratitis is a serious ocular condition, which can lead to corneal scarring, vision loss, and even blindness. Pediatric infectious keratitis accounts for about 13% of all cases, although there is a lack of comprehensive data regarding keratitis in less than two years of age population group. This study was aimed to determine predisposing factors, clinical characteristics, microbial profile, and management of infectious keratitis in a population of children aged less than two years.
A retrospective study was carried out in a tertiary eye institute over a period of 18 years from July 2005 to December 2022. Collected data was analyzed for demographics, predisposing factors, clinical features, and treatment methods.
Fifty-seven cases of keratitis were identified. Age of the patients ranged from 1 to 24 months (Median: 6, interquartile range: 2-10). Thirty cases were male (52.6%). Predisposing factors were identified in 39 cases (68.4%): consisting of prior ocular trauma (n = 15), previous intraocular surgery (n = 11), ocular surface disease (n = 10), nasolacrimal duct obstruction (n = 4), prematurity (n = 3), developmental delay (n = 2), TORCH infection (n = 1), and contact lens (n = 1). Corneal thinning was observed in 29 eyes (50.9%), which progressed to perforation in 13 eyes (22.8%). Three patients developed endophthalmitis (95% CI, 1.5-13.4%). Most eyes had negative smear (60.4%) and culture (59.6%) results. Pseudomonas aeruginosa was the most common microorganism (11 of 21). Candida albicans was isolated in one case. In vitro susceptibility results showed good coverage of the combined ceftazidime and vancomycin regimen (100%). Surgical procedures were carried out in 35 eyes (61.4%) and 15 eyes required tectonic procedures (26.3%).
Despite good coverage of medical treatment over cultured isolates, surgical tectonic intervention was required in nearly a quarter of cases to resolve the corneal infection. This finding indicates the necessity of prompt patient referring, corneal sampling and initiation of the treatment.
感染性角膜炎是一种严重的眼部疾病，可导致角膜瘢痕形成、视力丧失甚至失明。小儿感染性角膜炎约占所有病例的13%，尽管缺乏关于2岁以下人群角膜炎的全面数据。本研究旨在确定2岁以下儿童感染性角膜炎的易感因素、临床特征、微生物谱及治疗方法。
在一家三级眼科机构进行了一项为期18年的回顾性研究，时间从2005年7月至2022年12月。对收集的数据进行人口统计学、易感因素、临床特征和治疗方法分析。
共确诊57例角膜炎病例。患者年龄范围为1至24个月（中位数：6个月，四分位间距：2 - 10个月）。30例为男性（52.6%）。39例（68.4%）确定了易感因素：包括既往眼部外伤（n = 15）、既往眼内手术（n = 11）、眼表疾病（n = 10）、鼻泪管阻塞（n = 4）、早产（n = 3）、发育迟缓（n = 2）、TORCH感染（n = 1）和佩戴隐形眼镜（n = 1）。29只眼（50.9%）观察到角膜变薄，其中13只眼（22.8%）进展为穿孔。3例患者发生眼内炎（95%可信区间，1.5 - 13.4%）。大多数眼涂片（60.4%）和培养（59.6%）结果为阴性。铜绿假单胞菌是最常见的微生物（21例中的11例）。1例分离出白色念珠菌。体外药敏结果显示头孢他啶和万古霉素联合方案的覆盖效果良好（100%）。35只眼（61.4%）进行了手术，15只眼需要进行结构性手术（26.3%）。
尽管药物治疗对培养分离株的覆盖效果良好，但近四分之一的病例仍需要进行结构性手术干预以解决角膜感染。这一发现表明及时转诊患者、进行角膜采样和开始治疗的必要性。
