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Retrospective multifactorial analysis of Pythium keratitis and review of literature
PURPOSE: The aim of this work was to study the demographic profile, clinical diagnostic features, challenges in management, treatment outcomes, and ocular morbidity of microbiological culture-proven Pythium keratitis in a tertiary eye care hospital in South India. METHODS: Retrospective analysis of...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186601/ https://www.ncbi.nlm.nih.gov/pubmed/33913840 http://dx.doi.org/10.4103/ijo.IJO_1808_20 |
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author | Gurnani, Bharat Christy, Josephine Narayana, Shivananda Rajkumar, Purushothama Kaur, Kirandeep Gubert, Joseph |
author_facet | Gurnani, Bharat Christy, Josephine Narayana, Shivananda Rajkumar, Purushothama Kaur, Kirandeep Gubert, Joseph |
author_sort | Gurnani, Bharat |
collection | PubMed |
description | PURPOSE: The aim of this work was to study the demographic profile, clinical diagnostic features, challenges in management, treatment outcomes, and ocular morbidity of microbiological culture-proven Pythium keratitis in a tertiary eye care hospital in South India. METHODS: Retrospective analysis of microbiologically proven Pythium keratitis patients was performed at a tertiary eye center from October 2017 to March 2020. Demographic details, risk factors, microbiological investigations, clinical course, and visual outcomes were analyzed. RESULTS: Thirty patients were analyzed. The mean age was 43.1±17.2 years. Most common risk factors were history of injury in 80% and exposure to dirty water in 23.3%. Visual acuity at baseline was 20/30 to perception of light (PL). The most common clinical presentation was stromal infiltrate and hypopyon in 14 (46.6%) patients each. The microbiological confirmation was based on culture on blood agar and vesicles with zoospores formation with incubated leaf carnation method. Seven (23.3%) patients improved with topical 0.2% Linezolid and topical 1% Azithromycin, 19 (63.3%) patients underwent Therapeutic keratoplasty (TPK) and 4 were lost to follow-up. Seven (23.3%) patients had graft reinfection, and 3 (10%) developed endophthalmitis. The final visual acuity was 20/20- 20/200 in 6 (20%) patients, 20/240-20/1200 in 5 (16.6%) patients, hand movement to positive perception of light in 16 patients and no perception of light (Pthisis Bulbi) in 3 (10%) patients. CONCLUSION: P. insidiosum keratitis is a rapidly progressive infectious keratitis with prolonged and relapsing clinical course. It usually results in irreparable vision loss in majority of the patients. Prompt diagnosis, clinical awareness, and specific treatment options are needed for successfully managing this devastating corneal disease. |
format | Online Article Text |
id | pubmed-8186601 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-81866012021-06-10 Retrospective multifactorial analysis of Pythium keratitis and review of literature Gurnani, Bharat Christy, Josephine Narayana, Shivananda Rajkumar, Purushothama Kaur, Kirandeep Gubert, Joseph Indian J Ophthalmol Original Article PURPOSE: The aim of this work was to study the demographic profile, clinical diagnostic features, challenges in management, treatment outcomes, and ocular morbidity of microbiological culture-proven Pythium keratitis in a tertiary eye care hospital in South India. METHODS: Retrospective analysis of microbiologically proven Pythium keratitis patients was performed at a tertiary eye center from October 2017 to March 2020. Demographic details, risk factors, microbiological investigations, clinical course, and visual outcomes were analyzed. RESULTS: Thirty patients were analyzed. The mean age was 43.1±17.2 years. Most common risk factors were history of injury in 80% and exposure to dirty water in 23.3%. Visual acuity at baseline was 20/30 to perception of light (PL). The most common clinical presentation was stromal infiltrate and hypopyon in 14 (46.6%) patients each. The microbiological confirmation was based on culture on blood agar and vesicles with zoospores formation with incubated leaf carnation method. Seven (23.3%) patients improved with topical 0.2% Linezolid and topical 1% Azithromycin, 19 (63.3%) patients underwent Therapeutic keratoplasty (TPK) and 4 were lost to follow-up. Seven (23.3%) patients had graft reinfection, and 3 (10%) developed endophthalmitis. The final visual acuity was 20/20- 20/200 in 6 (20%) patients, 20/240-20/1200 in 5 (16.6%) patients, hand movement to positive perception of light in 16 patients and no perception of light (Pthisis Bulbi) in 3 (10%) patients. CONCLUSION: P. insidiosum keratitis is a rapidly progressive infectious keratitis with prolonged and relapsing clinical course. It usually results in irreparable vision loss in majority of the patients. Prompt diagnosis, clinical awareness, and specific treatment options are needed for successfully managing this devastating corneal disease. Wolters Kluwer - Medknow 2021-05 2021-04-30 /pmc/articles/PMC8186601/ /pubmed/33913840 http://dx.doi.org/10.4103/ijo.IJO_1808_20 Text en Copyright: © 2021 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Gurnani, Bharat Christy, Josephine Narayana, Shivananda Rajkumar, Purushothama Kaur, Kirandeep Gubert, Joseph Retrospective multifactorial analysis of Pythium keratitis and review of literature |
title | Retrospective multifactorial analysis of Pythium keratitis and review of literature |
title_full | Retrospective multifactorial analysis of Pythium keratitis and review of literature |
title_fullStr | Retrospective multifactorial analysis of Pythium keratitis and review of literature |
title_full_unstemmed | Retrospective multifactorial analysis of Pythium keratitis and review of literature |
title_short | Retrospective multifactorial analysis of Pythium keratitis and review of literature |
title_sort | retrospective multifactorial analysis of pythium keratitis and review of literature |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186601/ https://www.ncbi.nlm.nih.gov/pubmed/33913840 http://dx.doi.org/10.4103/ijo.IJO_1808_20 |
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