Fungal Keratitis: A Six-Year Review at a Tertiary Referral Centre.
Klin Monbl Augenheilkd
; 234(4): 419-425, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-28376553
ABSTRACT
Background This review reports the epidemiology, laboratory results, treatment regimens and costs of fungal keratitis at a tertiary referral center in Lucerne, Switzerland. Patients and Methods Culture-proven fungal infections between January 2010 and December 2015 were reviewed retrospectively. Results Seventeen patients with a mean age of 52 years were identified. Contact lens wear was the most important risk factor (n = 11) (65â% of all cases), with filamentous fungi being identified as the most common fungus type (n = 10) (91â% of all cases of contact lens-associated fungal keratitis). All non-contact lens-associated fungal infections (n = 6) (35â% of all cases) were related to Candida spp. Six patients (35â%) were treated on an outpatient basis; 11 cases (65â%) required hospitalisation. Systemic voriconazole was the treatment regimen prescribed most often (n = 12) (71â%), followed by topical natamycin 5â% (n = 11) (65â%). Corneal crosslinking and penetrating keratoplasty were required in 4 cases each (24â%). One case ended up in enucleation (6â%). Average costs per case were EUR 15â952 for hospitalised patients if surgical intervention was required, and EUR 7415 if no intervention was performed. Average costs for outpatients were EUR 7079. In a majority of cases, visual acuity could be improved (n = 9) (53â%) or preserved (n = 2) (12â%). Conclusion Despite the relatively low incidence of culture-proven keratitis (17 cases in 6 years), a clear pattern with regard to risk factors and fungus species was noted. In the absence of a gold standard for the treatment of fungal keratitis, the combination of systemic voriconazole and topical natamycin seems to be one of the most commonly used antifungal treatment regimens. The costs of outpatient versus inpatient non-surgical treatment were approximately the same.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Infecções Oculares Fúngicas
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Custos de Cuidados de Saúde
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Lentes de Contato
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Centros de Atenção Terciária
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Ceratite
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Klin Monbl Augenheilkd
Ano de publicação:
2017
Tipo de documento:
Article