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Predisposing Factors and Etiologic Diagnosis of Ulcerative Keratitis

Sirikul, Tasanee MD*†; Prabriputaloong, Tisha MD*; Smathivat, Achavee MD*; Chuck, Roy S MD, PhD; Vongthongsri, Anun MD*

doi: 10.1097/ICO.0b013e31815ca0bb
Clinical Science

Purpose: To determine the predisposing factors, demographic characteristics, and etiology of ulcerative keratitis in a referral center in Bangkok, Thailand.

Methods: The medical records of admitted patients with positive-culture ulcerative keratitis were retrospectively reviewed for demographic data, predisposing factors, and microbial culture results. Predisposing factors were compared between bacterial and fungal keratitis.

Results: From January 2001 to December 2004, there were 127 positive-culture ulcerative keratitis cases. The most frequent microbiological diagnosis was bacterial keratitis (76 eyes, 60%), followed by fungal (48 eyes, 38%) and Acanthamoeba keratitis (3 eyes, 2%). The most common organisms isolated were Pseudomonas spp. for bacteria and Fusarium spp. for fungus. Compared with bacterial keratitis, fungal keratitis was more likely to be associated with ocular trauma (odds ratio = 11.20; 95% confidence interval, 3.62-34.66) but less likely to be associated with contact lens wear (odds ratio = 0.02; 95% confidence interval, 0.01-0.08).

Conclusions: In our study, Pseudomonas and Fusarium species are the most common causes of bacterial and fungal keratitis, respectively. Fungal keratitis was more likely than bacterial keratitis to be associated with ocular trauma, whereas fungal keratitis was less likely to be associated with contact lens wear.

From the *Department of Ophthalmology, Ramathibodi Hospital School of Medicine, Mahidol University, Bangkok, Thailand; †Department of Ophthalmology, Thammasat Hospital, Thammasat University, Bangkok, Thailand; and ‡Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Received for publication February 2, 2007; revision received August 29, 2007; accepted September 29, 2007.

Reprints: Anun Vongthongsri, Department of Ophthalmology, Ramathibodi Hospital School of Medicine, Mahidol University, 270 Rama VI, Bangkok, Thailand (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.