Memorias del Instituto de Investigaciones en Ciencias de la Salud
versão On-line ISSN 1812-9528
ARRUA, M et al. Infectious keratitis: clinical and microbiological characteristics. 2003-2006 period. Mem. Inst. Investig. Cienc. Salud [online]. 2008, vol.6, n.1, pp. 05-14. ISSN 1812-9528.
Infectious keratitis cause significant morbidity and, if it is not promptly and appropriately treated, can lead to severe ocular disability. This retrospective study evaluates the clinical and microbiological characteristics of infectious keratitis, treatment and outcome at two month post-treatment in patients consulting at the Ophthalmology Department of the Teaching Hospital of the National University of Asunción from July 2003 to December 2006. Out of 167 patients, 74.3% were men; mean age ± SD was 40 years ± 19. In 71.9% of the cases cultures were positives; 43.7% were caused by bacteria; 17.4% to fungi, and 10.8% bacteria and fungi. The most frequently isolated bacteria were negative coagulase Staphylococcus (29%), followed by Pseudomonas aeruginosa (16%), Streptococcus pneumoniae (10.5%) and Staphylococcus aureus (8.1%). Fusarium sp. accounted for 57.4% of the fungi. Data on treatment was available on 154 patients, of whom 77.8% received a combination of cefazolin 50 mg/ml and gentamicin 16mg/ml; 33.5% fluconazole and 12% ciprofloxacin. The outcome at two month post-treatment was evaluated in 133 patients, of whom 82% showed leucoma, 13.5% conjunctival flap and 4.5% evisceration. A worse outcome was related to fungal etiology and ulcer large size. The frequency of fungal keratitis is high in this series, and is related to a worse evolution. Fluconazole is the only antifungal available in Paraguay and since its effect is mainly on non- filamentous fungi others antifungal drugs, as natamicin, should be considered for the treatment of fungal keratitis, in order to prevent vision loss of many patients.
Palavras-chave : infectious keratitis; bacteria; fungi; outcomes.