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...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118225000052 |
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| 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 |
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