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Acanthamoeba, Fungal, and Bacterial Keratitis: A Comparison of Risk Factors and Clinical Features

Authors
  • Mascarenhas, Jeena
  • Lalitha, Prajna
  • Prajna, N. Venkatesh
  • Srinivasan, Muthiah
  • Das, Manoranjan
  • D'Silva, Sean S.
  • Oldenburg, Catherine E.
  • Borkar, Durga S.
  • Esterberg, Elizabeth J.
  • Lietman, Thomas M.
  • Keenan, Jeremy D.1, 2, 3, 2, 4, 5, 6, 5, 7, 5
  • 1 Department of Cornea and External Diseases
  • 2 Aravind Eye Care System
  • 3 Department of Ocular Microbiology
  • 4 Francis I. Proctor Foundation
  • 5 University of California
  • 6 Department of Ophthalmology
  • 7 Department of Epidemiology & Biostatistics
Type
Published Article
Journal
American Journal of Ophthalmology
Publisher
Elsevier
Publication Date
Jan 01, 2014
Accepted Date
Aug 30, 2013
Volume
157
Issue
1
Pages
56–62
Identifiers
DOI: 10.1016/j.ajo.2013.08.032
Source
Elsevier
License
Unknown

Abstract

PurposeTo determine risk factors and clinical signs that may differentiate between bacterial, fungal, and acanthamoeba keratitis among patients presenting with presumed infectious keratitis. DesignHospital-based cross-sectional study. MethodsWe examined the medical records of 115 patients with laboratory-proven bacterial keratitis, 115 patients with laboratory-proven fungal keratitis, and 115 patients with laboratory-proven acanthamoeba keratitis seen at Aravind Eye Hospital, Madurai, India, from 2006-2011. Risk factors and clinical features of the 3 organisms were compared using multinomial logistic regression. ResultsOf 95 patients with bacterial keratitis, 103 patients with fungal keratitis, and 93 patients with acanthamoeba keratitis who had medical records available for review, 287 (99%) did not wear contact lenses. Differentiating features were more common for acanthamoeba keratitis than for bacterial or fungal keratitis. Compared to patients with bacterial or fungal keratitis, patients with acanthamoeba keratitis were more likely to be younger and to have a longer duration of symptoms, and to have a ring infiltrate or disease confined to the epithelium. ConclusionsRisk factors and clinical examination findings can be useful for differentiating acanthamoeba keratitis from bacterial and fungal keratitis.

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