Differential Clinical Features Of Bacterial And Fungal Keratitis
Published 2023 - 41st Congress of the ESCRS
Reference: PP06.03 | DOI: 10.82333/dhx6-cw04
Authors: Huy Ngoc Tran 1 , Huan Pham 2 , Thang Diep 2 , Mai Nguyen 3 , Nhut Vo 4 , Hieu Nguyen 4 , Vuong Nguyen 5 , Vinh Lam 2 , Chuc Nguyen 6 , Tram Duong* 7 , Simon Fung 8 , Huong Duong 9
1Ophthalmology Department,Cho Ray Hospital,Ho Chi Minh,Viet Nam;Cornea Department,Ho Chi Minh City Eye Hospital,Ho Chi Minh,Viet Nam;Ophthalmology Department,University of Medicine and Pharmacy at Ho Chi Minh City,Ho Chi Minh,Viet Nam, 2Cornea Department,Ho Chi Minh City Eye Hospital,Ho Chi Minh,Viet Nam, 3Cornea Department,Ho Chi Minh City Eye Hospital,Ho Chi Minh,Viet Nam;Ophthalmology Department,Pham Ngoc Thach University of Medicine,Ho Chi Minh,Viet Nam, 4Ophthalmology Department,University of Medicine and Pharmacy at Ho Chi Minh City,Ho Chi Minh,Viet Nam, 5Statistical Department,University of Medicine and Pharmacy at Ho Chi Minh City,Ho Chi Minh,Viet Nam, 6Ho Chi Minh City Ophthalmological Society,Ho Chi Minh,Viet Nam, 7School of Chemistry and Molecular Biosciences, The University of Queensland,Brisbane,Australia, 8Stein Eye Institute,Los Angeles,United States, 9Cornea Department,Ho Chi Minh City Eye Hospital,Ho Chi Minh,Viet Nam;Ophthalmology Department,University of Medicine and Pharmacy at Ho Chi Minh City,Ho Chi Minh,Viet Nam;Jio Health,Ho Chi Minh,Viet Nam
This study aims to define the differential clinical features of bacterial and fungal keratitis.
The research was conducted at the Cornea Department of the Ho Chi Minh City Eye Hospital between August 2019 and October 2021, with ethical approval obtained from the institutional review boards (IRBs) of University of Medicine and Pharmacy at Ho Chi Minh City (775/HĐĐĐ) and Pham Ngoc Thach University of Medicine (391/HĐĐĐ - TĐHYKPNT).
Study design
This is a prospective study analyzing 133 cases diagnosed with bacterial and fungal keratitis.
Participants
Bacterial and fungal keratitis were identified as the presence of an epithelial defect and stromal infiltrate, and positive diagnostic tests (fungal smear, fungal culture, and bacterial culture).
The research comprised of 133 cases of infectious keratitis, of which 23 were fungal keratitis and 110 were bacterial keratitis.
Univariate analysis revealed that eight characteristics were significantly more frequent in fungal keratitis compared to bacterial keratitis. Occupation, delayed onset (> 3 days), central infiltrate, larger infiltrate, elevated lesion, serrated margins, multifocal infiltrates, and pigmentation with odd ratios of 8.49, 3.06, 5.41, 7.40, 10.35, 50.97, 11.10, and 4.82 (p < 0.05), respectively.
Multivariate analysis of all factors did not yield any significant differences among the differential characteristics.
The study identified eight characteristics that can help distinguish between fungal keratitis and bacterial keratitis. These include agricultural occupation, delayed onset of symptoms (> 3 days), central infiltrate, larger infiltrate, elevated lesion, serrated margins, multifocal infiltrates, and pigmentation. Diagnostic tests remain critical in making the definite diagnosis. A study with larger sample size is being conducted to test the hypothesis of a prediction model that can potentially differentiate the two types of keratitis.