Objective: To analyze the etiological and clinical characteristics of 1054 cases with suppurative keratitis.
Methods: Medical records of 1054 inpatients with suppurative keratitis at the Qingdao Eye Hospital, Shandong Eye Institute from January 1999 to December 2004 were retrospectively reviewed for the analysis of demographic features, duration of symptoms, risk factors, previous therapy and laboratory findings.
Results: Fungal keratitis (61.9%) was the most common type in suppurative keratitis inpatients. Middle aged patients (between 41 - 50 years, 27.3%) and farm workers (82.9%) were the most common groups. Corneal trauma was noted as the most common risk factor. The positive rate of direct microscopic examination of potassium hydroxide (KOH) wet mounts was 88.7% for the diagnosis of fungal keratitis, but the positive rate of microscopic examination of Gram staining was only 43.4% in detecting bacterial keratitis. The most common type of fungi isolated was fusarium species (437 cases, 73.3%), followed by aspergillus species (72 cases, 12.1%). Pseudomonas aeruginosa was the most commonly isolated bacteria (35.7%), followed by staphylococcus epidermidis (22.5%).
Conclusions: Fungal keratitis is the most common type in severe suppurative corneal ulcers and its incidence shows an increasing tendency progressively. As a rapid, simple and effective diagnostic method of fungal keratitis, the application of direct microscopic examination of KOH wet mounts should be used more extensively. A rapid and effective detecting technique of bacterial keratitis is required urgently.