1. Factors Influencing Predilection and Outcome in Bacterial Keratitis
- Author
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Olafur G. Gudmundsson, L. David Ormerod, Kenneth R. Kenyon, Robert J. Glynn, Ann S. Baker, Joan Haaf, Steven Lubars, Mark B. Abelson, S. Arthur Boruchoff, C. Stephen Foster, Deborah Pavan-Langston, Richard A. Thoft, and Claes H. Dohlman
- Subjects
medicine.medical_specialty ,Visual acuity ,Topical Corticosteroid Therapy ,business.industry ,Pseudomonas aeruginosa ,Incidence (epidemiology) ,medicine.disease_cause ,law.invention ,Contact lens ,Ophthalmology ,Gram staining ,law ,Staphylococcus aureus ,Internal medicine ,Streptococcus pneumoniae ,medicine ,medicine.symptom ,business - Abstract
Complete records from 175 patients with 176 episodes of culture-proven bacterial keratitis treated over a 4-year period at the Massachusetts Eye and Ear Infirmary in Boston were analyzed. Sixty-three percent of the infections involved gram-positive organisms, and 40% involved gram-negative organisms; 15% were polymicrobial. There was a high incidence of infection with Staphylococcus aureus (28%), coagulase-negative staphylococci (14%), diphtheroids (14%), Pseudomonas aeruginosa (14%), and Streptococcus pneumoniae (12%). Gram stain correlation was achieved in 55%. Potential predisposing factors, usually multiple, were identified in 97% of the patients. Fifty percent of the ulcers were associated with such iatrogenic factors as prior topical corticosteroid therapy, penetrating keratoplasty, and contact lens use. Trauma occurred in only 16%. Several statistically significant associations of epidemiologic factors and outcome variables were revealed. Ninety-five percent of the ulcers resolved with therapy, but only 44% of the patients had visual acuity better than the level at admission, and 13% developed major complications.
- Published
- 1989
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