ArticleThe British journal of ophthalmology2006
Microbiological diagnosis of infective keratitis: comparative evaluation of direct microscopy and culture results.
Article in The British journal of ophthalmology, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
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Who cites it
48 citing papers in PubMed.
- Microscopic evaluation, molecular identification, antifungal susceptibility, and clinical outcomes in fusarium, Aspergillus and, dematiaceous keratitis.BioMed research international · 2013Trial
- Successful Medical Management of Pigmented Fungal Keratitis Following Vegetative Trauma.Annals of African medicine · 2026Article
- Fungal keratitis in Germany : Diagnostics, conservative and microsurgical treatment.Die Ophthalmologie · 2026Review
- A thirteen-year tertiary centre experience with infectious keratitis in the elderly population.International ophthalmology · 2026Article
- Nested PCR as a superior diagnostic method for Acanthamoeba keratitis compared to conventional techniques.Scientific reports · 2026Article
- Clinical features, microbiological characteristics, and treatment outcomes of fungal keratitis in a tertiary referral hospital in Eastern China.BMC infectious diseases · 2025Article
- [Fungal keratitis in Germany : Diagnostics, conservative and microsurgical treatment].Die Ophthalmologie · 2025Review
- Navigating the Challenges of Acanthamoeba Keratitis: Current Trends and Future Directions.Life (Basel, Switzerland) · 2025Review
- Acanthamoeba keratitis: from pathophysiology to prevention, a contemporary clinical perspective.Medical hypothesis, discovery & innovation ophthalmology journal · 2025Review
- Direct Cost Analysis of Microbial Keratitis in North China: A Hospital-Based Retrospective Study.Pathogens (Basel, Switzerland) · 2024Article
- Article
- Microbial keratitis and its management at a rural centre: achieving success with limited resources.International ophthalmology · 2024Article
- Understanding Acanthamoeba Keratitis: An In-Depth Review of a Sight-Threatening Eye Infection.Microorganisms · 2024Review
- Recent Advances in Diagnosis and Treatment Approaches in Fungal Keratitis: A Narrative Review.Microorganisms · 2024Review
- Debulking corneal biopsy with tectonic amniotic membrane transplantation in refractory clinically presumed fungal keratitis.Scientific reports · 2024Article
- Diagnosis ofDiagnostics (Basel, Switzerland) · 2023Review
- Clinical Characterization and Outcomes of Culture- and Polymerase Chain Reaction-Negative Cases of Infectious Keratitis.Diagnostics (Basel, Switzerland) · 2023Article
- Deep Convolutional Neural Networks Detect no Morphological Differences Between Culture-Positive and Culture-Negative Infectious Keratitis Images.Translational vision science & technology · 2023Article
- Challenges in the diagnosis and management of atypical fungal keratitis during the COVID-19 pandemic: a case series.Access microbiology · 2023Article
- Diagnosis of Fungal Keratitis in Low-Income Countries: Evaluation of Smear Microscopy, Culture, and In Vivo Confocal Microscopy in Nepal.Journal of fungi (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo determine the sensitivity, specificity and predictive values of potassium hydroxide (KOH) wet mount, Gram stain, Giemsa stain and Kinyoun's acid-fast stain in the diagnosis of infective keratitis.
methodsA retrospective analysis of all patients with clinically diagnosed infective keratitis presenting between September 1999 and September 2002 was carried out. Corneal scrapes were taken and subjected to direct microscopy and culture.
results3298 eyes of 3295 consecutive patients with infective keratitis were evaluated, of which 1138 (34.51%) eyes had fungal growth alone, 1069 (32.41%) had bacterial growth alone, 33 (1%) had Acanthamoeba growth alone, 83 (2.5%) had mixed microbial growth and the remaining 975 (29.56%) had no growth. The sensitivity of KOH wet mount was higher (99.3%; 95% confidence interval (CI) 98.6 to 99.6) in the detection of fungi, 100% (95% CI 90.4 to 100) in the detection of Nocardia and 91.4% (95% CI 75.8 to 97) in the detection of Acanthamoeba) than that of Gram-stained smears (89.2% (95% CI 87.3 to 90.8) in fungi, 87% (95% CI 73.0 to 94.6) in Nocardia and 60% (95% CI 42.2 to 75.6) in the detection of Acanthamoeba) in the detection of fungi, Nocardia and Acanthamoeba. 1764 of 3295 (53.54%) patients presented more than 7 days after onset of illness and 84.69% of the eyes had corneal ulcers with size >2 mm in diameter. Positivities of KOH (44.46%; p<0.001) and Gram-stained smears (77.37%; p<0.001) were found to be higher among eyes with larger ulcers (>2 mm) than among eyes with smaller ulcers (<2 mm).
conclusionKOH smear is of greater diagnostic value in the management of infective keratitis, and it is recommended in all clinics without exception for establishing timely treatment.
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