Acanthamoeba, fungal, and bacterial keratitis: a comparison of risk factors and clinical features

doi:10.1016/j.ajo.2013.08.032

Comparative Study

. 2014 Jan;157(1):56-62.

doi: 10.1016/j.ajo.2013.08.032. Epub 2013 Nov 5.

Acanthamoeba, fungal, and bacterial keratitis: a comparison of risk factors and clinical features

Affiliations

¹ Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
² Department of Ocular Microbiology, Aravind Eye Care System, Madurai, India.
³ Francis I. Proctor Foundation, University of California, San Francisco, California.
⁴ Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California; Department of Epidemiology & Biostatistics, University of California, San Francisco, California.
⁵ Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California. Electronic address: jeremy.keenan@ucsf.edu.

PMID: 24200232
PMCID: PMC3865075
DOI: 10.1016/j.ajo.2013.08.032

Comparative Study

Acanthamoeba, fungal, and bacterial keratitis: a comparison of risk factors and clinical features

Jeena Mascarenhas et al. Am J Ophthalmol. 2014 Jan.

. 2014 Jan;157(1):56-62.

doi: 10.1016/j.ajo.2013.08.032. Epub 2013 Nov 5.

Affiliations

¹ Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
² Department of Ocular Microbiology, Aravind Eye Care System, Madurai, India.
³ Francis I. Proctor Foundation, University of California, San Francisco, California.
⁴ Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California; Department of Epidemiology & Biostatistics, University of California, San Francisco, California.
⁵ Francis I. Proctor Foundation, University of California, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, California. Electronic address: jeremy.keenan@ucsf.edu.

PMID: 24200232
PMCID: PMC3865075
DOI: 10.1016/j.ajo.2013.08.032

Abstract

Purpose: To determine risk factors and clinical signs that may differentiate between bacterial, fungal, and acanthamoeba keratitis among patients presenting with presumed infectious keratitis.

Design: Hospital-based cross-sectional study.

Methods: We 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.

Results: Of 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.

Conclusions: Risk factors and clinical examination findings can be useful for differentiating acanthamoeba keratitis from bacterial and fungal keratitis.

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References

1. Stehr-Green JK, Bailey TM, Brandt FH, Carr JH, Bond WW, Visvesvara GS. Acanthamoeba keratitis in soft contact lens wearers. A case-control study. JAMA. 1987;258(1):57–60. - PubMed
1. Moore MB, McCulley JP, Luckenbach M, et al. Acanthamoeba keratitis associated with soft contact lenses. Am J Ophthalmol. 1985;100(3):396–403. - PubMed
1. Radford CF, Minassian DC, Dart JK. Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. Br J Ophthalmol. 2002;86(5):536–542. - PMC - PubMed
1. Van Meter WS, Musch DC, Jacobs DS, Kaufman SC, Reinhart WJ, Udell IJ. Safety of overnight orthokeratology for myopia: a report by the American Academy of Ophthalmology. Ophthalmology. 2008;115(12):2301–2313. e2301. - PubMed
1. Joslin CE, Tu EY, Shoff ME, et al. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol. 2007;144(2):169–180. - PMC - PubMed

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[1] Stehr-Green JK, Bailey TM, Brandt FH, Carr JH, Bond WW, Visvesvara GS. Acanthamoeba keratitis in soft contact lens wearers. A case-control study. JAMA. 1987;258(1):57–60. - PubMed

[2] Stehr-Green JK, Bailey TM, Brandt FH, Carr JH, Bond WW, Visvesvara GS. Acanthamoeba keratitis in soft contact lens wearers. A case-control study. JAMA. 1987;258(1):57–60. - PubMed

[3] Moore MB, McCulley JP, Luckenbach M, et al. Acanthamoeba keratitis associated with soft contact lenses. Am J Ophthalmol. 1985;100(3):396–403. - PubMed

[4] Moore MB, McCulley JP, Luckenbach M, et al. Acanthamoeba keratitis associated with soft contact lenses. Am J Ophthalmol. 1985;100(3):396–403. - PubMed

[5] Radford CF, Minassian DC, Dart JK. Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. Br J Ophthalmol. 2002;86(5):536–542. - PMC - PubMed

[6] Radford CF, Minassian DC, Dart JK. Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. Br J Ophthalmol. 2002;86(5):536–542. - PMC - PubMed

[7] Van Meter WS, Musch DC, Jacobs DS, Kaufman SC, Reinhart WJ, Udell IJ. Safety of overnight orthokeratology for myopia: a report by the American Academy of Ophthalmology. Ophthalmology. 2008;115(12):2301–2313. e2301. - PubMed

[8] Van Meter WS, Musch DC, Jacobs DS, Kaufman SC, Reinhart WJ, Udell IJ. Safety of overnight orthokeratology for myopia: a report by the American Academy of Ophthalmology. Ophthalmology. 2008;115(12):2301–2313. e2301. - PubMed

[9] Joslin CE, Tu EY, Shoff ME, et al. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol. 2007;144(2):169–180. - PMC - PubMed

[10] Joslin CE, Tu EY, Shoff ME, et al. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol. 2007;144(2):169–180. - PMC - PubMed

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Acanthamoeba, fungal, and bacterial keratitis: a comparison of risk factors and clinical features

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Acanthamoeba, fungal, and bacterial keratitis: a comparison of risk factors and clinical features

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