Tas Muhammed Dara, Palamar Melis, Aydemir Sabire Sohret, Selver Ozlem Barut
Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova-Izmir, Turkey.
Department of Microbiology, Ege University, Izmir, Turkey.
Int Ophthalmol. 2025 Mar 18;45(1):110. doi: 10.1007/s10792-025-03463-z.
To evaluate the demographic data, risk factors, clinical outcomes, microbial spectrum, and treatment in pediatric microbial keratitis cases.
The medical data including demographics, predisposing factors, accompanying diseases, clinical course, and microbial culture results was retrospectively evaluated. A total of 27 patients younger than 18 years who were diagnosed as microbial keratitis in a tertiary referral center between March 2019 and December 2023 were included in the study.
The male/female ratio was 14/13. The mean age was 13.02 ± 6.21 (range, 2-18) years. The most common risk factor was contact lens use (33.8%) followed by trauma (18.5%). The most common accompanied disease was acne rosacea (7.4%). In 20 cases (with a lesion greater than 2 mm in diameter, involving a layer deeper than half of the cornea, etc.) culture samples were taken. Cultures were positive for microbial growth in 8 (40.0%) patients and Pseudomonas aeruginosa was the most frequently isolated organism (25.0%). While 24 (88.8%) of the keratitis improved with medical treatment alone, additional corneal debridement was applied to 2 (7.4%) eyes, and therapeutic penetrating keratoplasty was performed in one refractory case.
Although rarer than adult cases, pediatric keratitis is an important entity in childhood due to difficulties and complications in history taking, examination and medication use. This study emphasizes the role of contact lens usage and trauma as the primary causes and Pseudomonas aeruginosa as the most frequent microorganism in pediatric keratitis. Identification of predisposing factors and microorganisms may be helpful for early recognition and treatment.
评估儿童微生物性角膜炎病例的人口统计学数据、危险因素、临床结局、微生物谱及治疗情况。
回顾性评估包括人口统计学、易感因素、伴发疾病、临床病程及微生物培养结果在内的医学数据。本研究纳入了2019年3月至2023年12月期间在一家三级转诊中心被诊断为微生物性角膜炎的27例18岁以下患者。
男女比例为14/13。平均年龄为13.02±6.21(范围2 - 18)岁。最常见的危险因素是佩戴隐形眼镜(33.8%),其次是外伤(18.5%)。最常见的伴发疾病是玫瑰痤疮(7.4%)。对20例(病变直径大于2mm,累及角膜深度超过一半等)进行了培养样本采集。8例(40.0%)患者培养出微生物生长,铜绿假单胞菌是最常分离出的病原体(25.0%)。24例(88.8%)角膜炎仅通过药物治疗得到改善,2例(7.4%)眼睛进行了额外的角膜清创术,1例难治性病例进行了治疗性穿透性角膜移植术。
尽管儿童角膜炎比成人病例少见,但由于病史采集、检查及用药方面的困难和并发症,它在儿童时期是一个重要问题。本研究强调了佩戴隐形眼镜和外伤作为儿童角膜炎主要病因的作用,以及铜绿假单胞菌作为最常见微生物的地位。识别易感因素和微生物可能有助于早期识别和治疗。