Abstract
The purpose of the study is to determine the microbiological etiology, epidemiological factors, and clinical profile and treatment outcomes of infective keratitis in Ophthalmology department, Minia University, Egypt. Prospective, nonrandomized, observational clinical series of cases, including 150 patients with mean age 30 (range 12 to 85years), 90 patients (60%) were males and 60 (40%) were females, clinically diagnosed as infective corneal ulcer, attending the Ophthalmology Department-Faculty of Medicine. Minia University, Minia, Egypt. From December 2018 to December 2020. Detailed history taking and all clinical findings were collected. Corneal scrapings were obtained from patients and subjected to staining and culture for bacterial and fungal pathogens; Bacterial and fungal growth were identified by standard laboratory procedures. Corneal trauma by a vegetative matter was the commonest risk factor associated with infective keratitis in 92 cases (61.3%). Smear and culture was positive in 83 cases (58.4%) of 142 corneal scrapings obtained, of which 60 cases were fungal (72.3%), 21 cases were bacterial (25.3%) and two cases were mixed bacterial and fungal (2.4%), Aspergillus species was the commonest fungal species isolated in fungal keratitis. One hundred forty-two cases (94.67%) healed completely with scar. Only six cases (4%) required evisceration due to aggressive presentation from the start and keratoplasty was performed for two cases (1.33%). Fungal keratitis was the commonest type in cases attending to our department. Adequate diagnosis, management and follow-up helped in achieving high successful curative outcomes. Clinical Trials.gov ID: NCT04894630. Time of registration 1 December 2018.
Highlights
Infective Keratitis is a serious condition that requires immediate and appropriate management to ensure the best anatomical and visual outcome for the patient. [1]Corneal infections are the leading cause of monocular blindness in some developing countries
Corneal trauma by a vegetative matter was the commesnest risk factor associated with infective keratitis in 92 cases (61.3%)
Smear and Culture was positive in 83 cases (58.4%) of 142 corneal scrapings obtained, of which 60 cases were fungal (72.3%), 21 cases were bacterial (25.3%) and 2 cases were mixed bacterial and fungal (2.4%), Aspergillus species was the commonest fungal species isolated in fungal keratitis. 142 cases (94.67 %) healed completely with scar
Summary
Infective Keratitis is a serious condition that requires immediate and appropriate management to ensure the best anatomical and visual outcome for the patient. Corneal infections are the leading cause of monocular blindness in some developing countries. The identification of the causative organism is important for the selection of the appropriate type of antimicrobial agent and to avoid the unnecessary use of ineffective and potentially toxic drugs. Epidemiological and microbiological profile of corneal ulceration has been found to vary with patient population, health of cornea, geographical location and climate. We aim to report the epidemiology, the predisposing factors, microbiological profile and the outcome of management of bacterial and fungal corneal ulcers in patients presenting to ophthalmology outpatient clinic at faculty of Medicine, Minia University, Egypt
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