Clinical differentiation of Pythium keratitis from fungal keratitis and development of a scoring system

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dc.contributor.authorChatterjee, Samraten_US
dc.contributor.authorAgrawal, Deepshikhaen_US
dc.contributor.authorGomase, Sharad Nivruttien_US
dc.date.accessioned2023-08-25T06:34:52Z
dc.date.available2023-08-25T06:34:52Z
dc.date.issued2022-10
dc.description.abstractPurpose: To differentiate Pythium keratitis from fungal keratitis using clinical signs, to explore usefulness of various signs as diagnostic prognosticators, and develop a clinical scoring system. Methods: A retrospective review of medical records and archived clinical photographs of patients with culture?positive Pythium keratitis and hyaline filamentous fungal keratitis was conducted at a tertiary eye institute to explore characteristics of ulcers that may aid diagnosis. Results: Full?thickness corneal stromal keratitis (P = 0.055), a dry ulcer surface (P = 0.010), tentacles (P < 0.0001), intrastromal dots (P < 0.0001), ring infiltrates (P = 0.024), reticular patterns (P < 0.0001), and peripheral furrows (P < 0.0001) were clinical signs associated with Pythium keratitis. Multiple regression analysis identified tentacles (odds ratio: 24.1, 95% confidence interval (CI): 3.8–158.1, P = 0.001) and peripheral furrows (odds ratio: 60.6, 95% CI: 5.1–712.3, P = 0.001) as independent diagnostic prognosticators for Pythium keratitis. The positive and negative likelihood ratios of a dry ulcer surface, tentacles, intrastromal dots, ring infiltrates, reticular patterns, and peripheral furrows predicting Pythium keratitis were 1.6, 13.6, 17.9, 4.3, 30.7, 15.3 and 0.4, 0.4, 0.7, 0.9, 0.6 and 0.8, respectively. The presence of two or more of these clinical signs (excluding a dry ulcer surface) had a sensitivity of 55.6% and a false positive rate of 1.4%. Conclusion: Tentacles, intrastromal dots, ring infiltrates, reticular patterns, and peripheral furrows are clinical signs to be considered for the diagnosis of Pythium keratitis and the presence of two or more signs has a very low false positive rateen_US
dc.identifier.affiliationsCornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, Indiaen_US
dc.identifier.citationChatterjee Samrat, Agrawal Deepshikha, Gomase Sharad Nivrutti. Clinical differentiation of Pythium keratitis from fungal keratitis and development of a scoring system. Indian Journal of Ophthalmology. 2022 Oct; 70(10): 3515-3521en_US
dc.identifier.issn1998-3689
dc.identifier.issn0301-4738
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/224661
dc.languageenen_US
dc.publisherAll India Ophthalmological Societyen_US
dc.relation.issuenumber10en_US
dc.relation.volume70en_US
dc.source.urihttps://doi.org/10.4103/ijo.IJO_870_22en_US
dc.subjectClinical diagnosisen_US
dc.subjectfungal keratitisen_US
dc.subjectmicrobial keratitisen_US
dc.subjectpythium keratitisen_US
dc.subjectscoring systemen_US
dc.subjectsignsen_US
dc.titleClinical differentiation of Pythium keratitis from fungal keratitis and development of a scoring systemen_US
dc.typeJournal Articleen_US
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