Abstract
To describe the clinical and epidemiological characteristics of patients with severe infectious keratitis in Asunción, Paraguay between April 2009 and September 2011. All patients with the clinical diagnosis of severe keratitis (ulcer ≥2 mm in size and/or central location) were included. Empiric treatment consisted of topical antibiotics and antimycotics; in cases of advanced keratitis, fortified antibiotics were used. After microbiological analysis, treatment was changed if indicated. In total 48 patients (62.5 % males, 25 % farmers) were included in the analysis. A central ulcer was found in 81.3 % (n = 39). The median delay between onset of symptoms and time of first presentation at our institution was 7 days (range 1–30 days). Fungal keratitis was diagnosed in 64.5 % (n = 31) of patients, of which Fusarium sp. (n = 17) was the most common. Twenty-one patients (43.8 %) reported previous trauma to the eye. The globe could be preserved in all cases. While topical therapy only was sufficient in most patients, a conjunctival flap was necessary in six patients suffering from fungal keratitis. The high rate of fungal keratitis in this series is remarkable, and microbiological analysis provided valuable information for the appropriate treatment. In this setting, one has to be highly suspicious of fungal causes of infectious keratitis.
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Pascolini D, Mariotti SP (2012) Global estimates of visual impairment: 2010. Br J Ophthalmol 96(5):614–618
Whitcher JP, Srinivasan M, Upadhyay MP (2001) Corneal blindness: a global perspective. Bull World Health Organ 79(3):214–221
Shah A, Sachdev A, Coggon D, Hossain P (2011) Geographic variations in microbial keratitis: an analysis of the peer-reviewed literature. Br J Ophthalmol 95(6):762–767
Prokosch V, Gatzioufas Z, Thanos S, Stupp T (2012) Microbiological findings and predisposing risk factors in corneal ulcers. Graefe’s Arch Clin Exp Ophthalmol 250(3):369–374
Karsten E, Watson SL, Foster LJ (2012) Diversity of microbial species implicated in keratitis: a review. Open Ophthalmol J 6:110–124
Laspina F, Samudio M, Cibils D, Ta CN, Farina N, Sanabria R, Klauss V, Mino de Kaspar H (2004) Epidemiological characteristics of microbiological results on patients with infectious corneal ulcers: a 13-year survey in Paraguay. Graefe’s Arch Clin Exp Ophthalmol 242(3):204–209
Passos RM, Cariello AJ, Yu MC, Hofling-Lima AL (2010) Microbial keratitis in the elderly: a 32-year review. Arquivos Brasileiros de Oftalmologia 73(4):315–319
Kumar A, Pandya S, Kavathia G, Antala S, Madan M, Javdekar T (2011) Microbial keratitis in Gujarat, Western India: findings from 200 cases. Pan Afr Med J 10:48
Mino de Kaspar H, Zoulek G, Paredes ME, Alborno R, Medina D, Centurion de Morinigo M, Ortiz de Fresco M, Aguero F (1991) Mycotic keratitis in Paraguay. Mycoses 34(5–6):251–254
Basak SK, Basak S, Mohanta A, Bhowmick A (2005) Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, eastern India. Indian J Ophthalmol 53(1):17–22
Sirikul T, Prabriputaloong T, Smathivat A, Chuck RS, Vongthongsri A (2008) Predisposing factors and etiologic diagnosis of ulcerative keratitis. Cornea 27(3):283–287
Dalmon C, Porco TC, Lietman TM, Prajna NV, Prajna L, Das MR, Kumar JA, Mascarenhas J, Margolis TP, Whitcher JP, Jeng BH, Keenan JD, Chan MF, McLeod SD, Acharya NR (2012) The clinical differentiation of bacterial and fungal keratitis: a photographic survey. Invest Ophthalmol Vis Sci 53(4):1787–1791
Gonzales CA, Srinivasan M, Whitcher JP, Smolin G (1996) Incidence of corneal ulceration in Madurai district, South India. Ophthalmic Epidemiol 3(3):159–166
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Nentwich, M.M., Bordón, M., di Martino, D.S. et al. Clinical and epidemiological characteristics of infectious keratitis in Paraguay. Int Ophthalmol 35, 341–346 (2015). https://doi.org/10.1007/s10792-014-9951-7
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DOI: https://doi.org/10.1007/s10792-014-9951-7