Aetiology of microbial keratitis in northern Tanzania

The incidence of corneal blindness caused by microbial keratitis in the developing world is far higher than that in the developed world. 1 Microbial keratitis has become a more prominent cause of corneal blindness in east Africa as the uptake of measles immunisation improves, reducing measles keratitis scarring, and with improved recognition and treatment of vitamin A deficiency, reducing its associated xerophthalmia and subsequent corneal scarring. Characteristics Range Median Age (years) 8-97 44 Time from onset of symptoms to presentation (days) 1-90 10 Number % Sex Male 29 65.9 Female 15 34.1 Occupation Agricultural 22 50 Student/school 6 13.6 Driver/conductor 4 9.1 Maasai* 4 9.1 Retired 4 9.1 Soldier/guard 1 2.3 Miner 1 2.3 Teacher 1 2.3 Businessman 1 2.3 Treatment before presentation at KCMC of all cases (culture negative cases only) Nil 11 (6) 25 Local remedy 4 (2) 9.1 Inappropriate treatment 3 (1) 6.8 "Appropriate"[dagger] treatment, inadequate intensity 18 (5) 40.9 "Appropriate"[dagger] treatment 4 (2) 9.1 Unknown 4 (2) 9.1 History Vegetative trauma 14 32 All trauma 17 38.6 Previous corneal scar 14 32 Lid problems 2 4.6 Nil 11 25 Organisms cultured Fungi Fusarium solani 4 9.1 Fusarium sp 5 11.4 Aspergillus fumigatus 1 2.3 Cladosporium sp + Bacillus sp 1 2.3 Unidentified fungus + Staph epidermidis 1 2.3 All fungi 12 27.3 Gram positive bacteria Staphylococcus epidermidis 3 6.8 Staphylococcus aureus 2 4.6 Gram negative bacteria Pseudomonas aeruginosa 6 13.6 Proteus sp 1 2.3 No organism cultured 20 45.5 *Tribal herdsmen. [dagger]Empirical treatment with broad spectrum topical antibiotic.