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R. Limaiem, H. Lamloum, N. Ben Ayed, A. Merdassi, F. Mghaieth, L. El Matri; Risk Factors, Causative Organisms and Clinical Outcomes in 175 Cases of Microbial Keratitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2418.
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to identify risk factors, microbiological findings and clinical outcome of severe infective keratitis.
all cases of presumed infective keratitis admitted at the institute of ophthalmology (department B) between January 2000 and august 2008 were identified. Medical records of all patients were retrospectively reviewed with respect to clinical features, risk factors, management, and outcome.
one hundred and seventy five patients were admitted with a diagnosis of presumed microbial keratitis during the study period. The mean age of patients at the time of diagnosis was 62,75 years (range: 6 months - 97years), and the male to female ratio was 89/86 (50,85%,49,14%).The mean time from first symptoms or signs and presentation to hospital was 16 days. The majority of patients, 70,28% had at least one of the risk factors commonly associated with infective keratitis including ocular surface disease (22,85%), previous ocular surgery (19,42%), contact lens wear (9,7%), topical corticosteroid use (21,14%), and ocular trauma (26,85%).An organism was identified in 56,57% of cases. Sixty eight percent of all positive cultures involved gram positive bacteria. The most common isolates identified were staphylococcus epidermidis (42%), pseudomonas (16%) and streptococcus pneumonia (8%). In addition, fungi were isolated in 9%.The mean hospital stay was 14±6 days. Longer duration of stay was associated with the presence of hypopion, larger ulcers, previous ocular surgery, and poor visual acuity.
infectious keratitis is an important cause of ocular morbidity. The role of initial therapy for microbial keratitis remains important. Many cases of severe keratitis might be avoided, or their severity reduced, by appropriate education of patients and ophthalmologists.
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