PCR-based diagnosis and clinical insights into parasitic keratitis

Purpose: This retrospective study aimed to investigate demographic characteristics, predisposing factors, and clinical outcomes in patients with parasitic keratitis. Methods: Medical records of patients with molecularly confirmed Acanthamoeba or microsporidia, identified through corneal scraping spe...

Full description

Saved in:
Bibliographic Details
Main Authors: Suan Hwang, I-Huang Lin, Chun-Chieh Lai, Fu-Chin Huang, Sung-Huei Tseng, Yi-Chen Chen, Chung-Han Ho, Wei-Chen Lin, Yi-Hsun Huang
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Microbiology, Immunology and Infection
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1684118225000052
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849321544586625024
author Suan Hwang
I-Huang Lin
Chun-Chieh Lai
Fu-Chin Huang
Sung-Huei Tseng
Yi-Chen Chen
Chung-Han Ho
Wei-Chen Lin
Yi-Hsun Huang
author_facet Suan Hwang
I-Huang Lin
Chun-Chieh Lai
Fu-Chin Huang
Sung-Huei Tseng
Yi-Chen Chen
Chung-Han Ho
Wei-Chen Lin
Yi-Hsun Huang
author_sort Suan Hwang
collection DOAJ
description Purpose: This retrospective study aimed to investigate demographic characteristics, predisposing factors, and clinical outcomes in patients with parasitic keratitis. Methods: Medical records of patients with molecularly confirmed Acanthamoeba or microsporidia, identified through corneal scraping specimens (collected between September 21, 2017, and June 27, 2023), were reviewed. Demographic data, clinical profiles, such as symptom duration before confirmed diagnosis, antiviral treatment pre-diagnosis, contact lens use, tap water and soil contamination, ocular trauma, and treatment regimens, were analyzed. Results: Fifty PCR-confirmed cases included 35 Acanthamoeba keratitis (AK) and 15 microsporidia keratitis (MK). Of these, 23 males and 27 females, aged 8 to 81, showed a significant difference (p = 0.02) in the distribution of farmers between the AK and MK groups. Mean symptom durations pre-diagnosis were 27.6 days (range: 1–180) in AK and 11.47 days (range: 1–60) in MK. AK cases exhibited a higher prevalence of stromal involvement (p < 0.05) and contact lens use (p < 0.001), while more MK patients had a history of soil contamination (p = 0.016). Univariable analysis linked stromal keratitis, symptom duration, and pre-diagnosis antiviral treatment to prolonged time to stability. In the multivariable model, only symptom duration predicted extended time to stability, with an expected increase of 0.65 days for each additional pre-diagnosis day. Conclusion: This study underscores the significance of parasitic keratitis in Southern Taiwan, emphasizing the necessity of incorporating PCR as an effective diagnostic tool to enhance the routine identification of these rare conditions, moving beyond reliance on standard conventional methods.
format Article
id doaj-art-46a4bf7b1c7f4664ab04de094d38a8c5
institution Kabale University
issn 1684-1182
language English
publishDate 2025-06-01
publisher Elsevier
record_format Article
series Journal of Microbiology, Immunology and Infection
spelling doaj-art-46a4bf7b1c7f4664ab04de094d38a8c52025-08-20T03:49:44ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822025-06-0158336336710.1016/j.jmii.2025.01.002PCR-based diagnosis and clinical insights into parasitic keratitisSuan Hwang0I-Huang Lin1Chun-Chieh Lai2Fu-Chin Huang3Sung-Huei Tseng4Yi-Chen Chen5Chung-Han Ho6Wei-Chen Lin7Yi-Hsun Huang8Department of Ophthalmology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan, Taiwan; Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, TaiwanDepartment of Parasitology, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan; Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan; Corresponding author. Department of Parasitology, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Corresponding author.Purpose: This retrospective study aimed to investigate demographic characteristics, predisposing factors, and clinical outcomes in patients with parasitic keratitis. Methods: Medical records of patients with molecularly confirmed Acanthamoeba or microsporidia, identified through corneal scraping specimens (collected between September 21, 2017, and June 27, 2023), were reviewed. Demographic data, clinical profiles, such as symptom duration before confirmed diagnosis, antiviral treatment pre-diagnosis, contact lens use, tap water and soil contamination, ocular trauma, and treatment regimens, were analyzed. Results: Fifty PCR-confirmed cases included 35 Acanthamoeba keratitis (AK) and 15 microsporidia keratitis (MK). Of these, 23 males and 27 females, aged 8 to 81, showed a significant difference (p = 0.02) in the distribution of farmers between the AK and MK groups. Mean symptom durations pre-diagnosis were 27.6 days (range: 1–180) in AK and 11.47 days (range: 1–60) in MK. AK cases exhibited a higher prevalence of stromal involvement (p < 0.05) and contact lens use (p < 0.001), while more MK patients had a history of soil contamination (p = 0.016). Univariable analysis linked stromal keratitis, symptom duration, and pre-diagnosis antiviral treatment to prolonged time to stability. In the multivariable model, only symptom duration predicted extended time to stability, with an expected increase of 0.65 days for each additional pre-diagnosis day. Conclusion: This study underscores the significance of parasitic keratitis in Southern Taiwan, emphasizing the necessity of incorporating PCR as an effective diagnostic tool to enhance the routine identification of these rare conditions, moving beyond reliance on standard conventional methods.http://www.sciencedirect.com/science/article/pii/S1684118225000052Acanthamoeba keratitisMicrosporidial keratitisParasitic keratitisPolymerase chain reaction
spellingShingle Suan Hwang
I-Huang Lin
Chun-Chieh Lai
Fu-Chin Huang
Sung-Huei Tseng
Yi-Chen Chen
Chung-Han Ho
Wei-Chen Lin
Yi-Hsun Huang
PCR-based diagnosis and clinical insights into parasitic keratitis
Journal of Microbiology, Immunology and Infection
Acanthamoeba keratitis
Microsporidial keratitis
Parasitic keratitis
Polymerase chain reaction
title PCR-based diagnosis and clinical insights into parasitic keratitis
title_full PCR-based diagnosis and clinical insights into parasitic keratitis
title_fullStr PCR-based diagnosis and clinical insights into parasitic keratitis
title_full_unstemmed PCR-based diagnosis and clinical insights into parasitic keratitis
title_short PCR-based diagnosis and clinical insights into parasitic keratitis
title_sort pcr based diagnosis and clinical insights into parasitic keratitis
topic Acanthamoeba keratitis
Microsporidial keratitis
Parasitic keratitis
Polymerase chain reaction
url http://www.sciencedirect.com/science/article/pii/S1684118225000052
work_keys_str_mv AT suanhwang pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT ihuanglin pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT chunchiehlai pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT fuchinhuang pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT sunghueitseng pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT yichenchen pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT chunghanho pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT weichenlin pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis
AT yihsunhuang pcrbaseddiagnosisandclinicalinsightsintoparasitickeratitis