Korean J Med Mycol.  2015 Dec;20(4):83-92. 10.17966/KJMM.2015.20.4.83.

Analysis of Clinical Manifestations and Risk Factors for Treatment Failure in Fungal Keratitis

• Lee DH
• Ko HC
• Lee JE

• KMID: 2140274
• DOI: http://doi.org/10.17966/KJMM.2015.20.4.83

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.

Keyword

Clinical manifestation; Fungal keratitis; Risk factor; Treatment failure

MeSH Terms

Aspergillus
Candida
Fusarium
Humans
Keratitis*
Logistic Models
Male
Penicillium
Retrospective Studies
Risk Factors*
Treatment Failure*
Treatment Outcome
Vegetables