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Amaç: Bu çalışmada, kliniğimizde mikrobiyal keratit tanısı ile yatırarak takip ettiğimiz hastaların epidemiyolojik özelliklerini, klinik bulgularını, risk faktörlerini, direkt bakı ve kültür sonuçlarını inceleyip, bölgemizdeki etken mikroorganizmaları ve risk faktörlerini değerlendirerek ampirik tedavi protokolümüzü gözden geçirmeyi amaçladık. Gereç ve Yöntem: Haziran 2017 ile Haziran 2018 tarihleri arasında kliniğimizde keratit tanısı ile yatırarak takip ettiğimiz hastaların dosyaları retrospektif olarak incelendi. Klinik bulgular, risk faktörleri, mikrobiyolojik bulgular, ampirik tedavi ve tedaviye alınan yanıtlar değerlendirildi. Bulgular: 9 erkek, 9 kadın olmak üzere 18 hastanın 18 gözü değerlendirildi.(ort.yaş 67.8) Olguların %27.8’inde mikrobiyolojik bulguya rastlanıldı. %27.9’unda predispozan faktör olduğu görüldü. Tedavi öncesi görme keskinlikleri değerlendirildiğinde %11.1’i ışık hissi negatif, %16.7’si ışık hissi pozitif, %38,9’u el hareketleri pozitif, %16.7’si parmak sayma, %16.7’si 0.05 ve üzeriydi. Tedaviye alınan klinik yanıt değerlendirildiğinde hastaların % 72.2 sinde olumlu yanıt görüldü. Tedavi sonrası görme keskinliklerine baktığımızda, %11.1’i ışık hissi negatif, %5.6’sı ışık hissi pozitif, %33.3’ü el hareketleri, %27.8’i parmak sayma, %22.2’si 0.05 ve üzerindeydi. Taburculuk esnasındaki en yüksek görme keskinliği 0.1’di. Sonuç: Keratitler tek taraflı körlüğün önde gelen sebeplerindendir. Erken tanı ve tedavisinin prognozu belirlemedeki rolü büyüktür. Bölgesel risk faktörleri ve o bölgede en sık saptanan patojenler göz önüne alınarak uygun ampirik tedavi ile başarı sağlanabilir. Kültür-antibiyogram ve direkt mikroskobik bakı ise tedaviye yanıt alınamayan olgularda ciddi destek sağlamaktadır.
Purpose: In this study, we investigated epidemiological properties, clinical findings, risk factors, direct microscopy and culture results in the inpatients diagnosed with microbial keratitis. Our objective is to revise our empirical treatment procedure after evaluating causative microorganisms in our region and risk factors. Materials and Methods: We examined the hospital records of inpatients with microbial keratitis between June 2017 and June 2018, retrospectively. Also, clinical findings, risk factors, microbiological results, empirical treatment and treatment response were evaluated. Results: Eighteen eyes of 18 patients were examined, 9 female and 9 male, average age was 67.8. The 27.8 percent of the eyes had microbiological findings. The risk factors found in 27.9% of patients. The vision acuities (VA) before the treatment were : light perception (LP) negative 11.1 %; LP positive 16.7 %; hand motion (HM) 38.9 %; counting fingers 16.7 %, 0.05 and above 16.7 %. The empirical treatment was started for all of the patients. The clinical response of empirical antimicrobial therapy was detected in 72.2% of the patients. The vision acuities (VA) after the treatment were: light perception (LP) negative 11.1 %; LP positive 5.6 %; hand motion (HM) 33.3 %; counting fingers 27.8 %, 0.05 and above 22.2 %. The highest vision acuity was 0.1. The keratitis is a common cause of unilateral blindness. Early diagnosis and treatment of keratitis is a significant role on the prognosis. The success of the therapy can be provided starting empirical antimicrobial therapy by taking into account of the regional risk factors and common pathogens. On the other hand, direct microscopy and culture-antibiogram provide serious support in cases where the treatment response is not available.
Purpose: In this study, we investigated epidemiological properties, clinical findings, risk factors, direct microscopy and culture results in the inpatients diagnosed with microbial keratitis. Our objective is to revise our empirical treatment procedure after evaluating causative microorganisms in our region and risk factors. Materials and Methods: We examined the hospital records of inpatients with microbial keratitis between June 2017 and June 2018, retrospectively. Also, clinical findings, risk factors, microbiological results, empirical treatment and treatment response were evaluated. Results: Eighteen eyes of 18 patients were examined, 9 female and 9 male, mean age was 67.8. The 27.8 percentage of the eyes had microbiologic finding. The risk factors found in 27.9% of patients. The vision acuities (VA) before the treatment were : light perception (LP) negative 11.1 %; LP positive 16.7 %; hand motion (HM) 38.9 %; counting fingers 16.7 %, 0.05 and above 16.7 %. The empirical treatment was started for all of the patients. The clinical response of empirical antimicrobial therapy was detected in 72.2 % of the patients. The vision acuities (VA) after the treatment were: light perception (LP) negative 11.1 %; LP positive 5.6 %; hand motion (HM) 33.3 % ; counting fingers 27.8 %, 0.05 and above 22.2 %. The highest vision acuity was 0.1. Conclusion: The keratitis is a common cause of unilateral blindness. Early diagnosis and treatment of the keratitis is a significant role on the prognosis. The success of the therapy can be provided starting empirical antimicrobial therapy by taking into consideration of the regional risk factors and common pathogens. On the other hand, direct microscopy and culture-antibiogram provide serious support in cases where the treatment response is not available.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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