Clinical and microbiological profile of pediatric infectious keratitis

Purpose: Corneal ulcers are more prevalent in tropical developing countries. The purpose of this study is to report the risk factors, microbiological profile, and treatment outcomes of infectious keratitis in children. Materials and Methods: Retrospective case series of 77 consecutive children aged 16 years or younger with a diagnosis of infectious keratitis treated at the cornea service of a tertiary eye care institute. Patient demographics, predisposing factors, microbial susceptibility, microbial smear and culture results, clinical course, and visual outcomes were analyzed. Results: The average age of patients was 9.1 years (range 8 days–16 years). The mean time from the onset of symptoms to the ophthalmological examination was 14.6 (18.9) days. The most common associated risk factor was ocular trauma (n = 32, 43%). A total of 32 (32/77, 42%) eyes were positive on the smear examination. Bacterial infection was reported in 30 (30/77, 39%) and fungal infection was reported in 9 (9/77, 12%) children. Staphylococcus was the most commonly isolated organism (13/39, 33%) followed by Streptococcus (9/39, 23%), Pseudomonas (6/39, 15%), and Fusarium spp. (6/39, 15%). Curvularia spp. was also identified in 3 (3/39, 8%) eyes. Nineteen (19/77, 25%) children require surgical intervention. Therapeutic penetrating keratoplasty was needed in two children. Conclusion: Contrary to previous reports, bacteria are more frequent etiological organisms than fungi causing pediatric infectious keratitis in this study population. Staphylococcus spp. was the most predominant causative organism. Curvularia was not identified in previously reported studies from India. Most of the patients were managed medically. Surgical intervention was less frequent.