Analysis of Clinical Manifestations and Risk Factors for Treatment Failure in Fungal Keratitis.
10.17966/KJMM.2015.20.4.83
- Author:
Dong Hyun LEE
1
;
Hyun Chang KO
;
Ji Eun LEE
Author Information
1. Department of Ophthalmology, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea. jiel75@hanmail.net
- Publication Type:Original Article
- Keywords:
Clinical manifestation;
Fungal keratitis;
Risk factor;
Treatment failure
- MeSH:
Aspergillus;
Candida;
Fusarium;
Humans;
Keratitis*;
Logistic Models;
Male;
Penicillium;
Retrospective Studies;
Risk Factors*;
Treatment Failure*;
Treatment Outcome;
Vegetables
- From:Korean Journal of Medical Mycology
2015;20(4):83-92
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Fungal keratitis is common cause of corneal infection. If not diagnosed and treated promptly and effectively, significant damage can occur. OBJECTIVE: To investigate the clinical manifestations and risk factors for treatment failure in fungal keratitis. METHODS: A total of 23 patients with fungal keratitis, who were diagnosed by clinical findings, smears, and cultures and followed up for at least 6 months, were studied retrospectively. Age, sex, previous history of trauma, corticosteroid use, previous ocular disease and surgery, systemic diseases, causative organism, features of keratitis, and treatment results were reviewed. A logistic regression analysis was performed to identify the prognostic risk factors. RESULTS: Thirteen patients (57%) were male and mean age was 57 +/- 18 years. Trauma with vegetable matter (30%) was most commonly noted. The causative organisms were identified in 18 eyes (78%) and Aspergillus sp. (7 eyes, 30%) was the most common detected followed by Candida sp. (6 eyes, 26%), Fusarium sp. (3 eyes, 13%) and Penicillium sp. (2 eyes, 9%). A lesion located in the central area was 13 eyes (57%) and exceeding 10 mm2 in size was 15 eyes (65%). Hypopyon was found in 7 eyes (30%). Treatment failed in 9 eyes (39%), and predictor of treatment failure was a lesion exceeding 10 mm2 (p < 0.05). CONCLUSION: Risk factor for treatment failure included a large lesion size. Therefore, an effort should be made to discern the clinical features of fungal keratitis and to determine appropriate early treatment for a successful treatment outcome.
