Outbreak of Fusarium keratitis - Hong Kong experience

Abstract

Aim: To describe a regional outbreak of Fusarium keratitis among contact lens wearers in Hong Kong. Methods: In this retrospective hospital-based study, all cases of fungal keratitis among contact lens wearers receiving treatment in 1 of the 7 hospital clusters in Hong Kong (United Christian Hospital and Tseung Kwan O Hospital)from May 2005 to September 2006 were reviewed. Additional clinical information was obtained through telephone interviews conducted by the same trained interviewer. Results: Fourteen patients (16 affected eyes) were identified as contact lens wearers with culture positive Fusarium keratitis during the study period. The mean age was 31.3 years (SD, 9.4 years; range, 18 to 49 years) with female predominance (male to female ratio, 3:11). Eleven of 12 patients (92%) reported using ReNu MoistureLoc multipurpose contact lens solution prior to the onset of infection. The onset of symptoms ranged from 1 to 7 days (average, 2.5 days). Five patients (36%) were treated with topical antibiotics without the need for specific antifungal therapy. Nine patients (64%) were treated with topical antifungal therapy. No patients required therapeutic penetrating keratoplasty. Fourteen eyes (87.5%) resolved with vision 20/40 or better and no eyes had vision 20/60 or worse. No recurrence of fungal lesions was noted. Conclusions: These findings showed that the majority of the affected patients were using ReNu solution prior to infection. Early commencement of either intensive topical broad-spectrum antibiotics or antifungal treatment was associated with improved visual outcome. © 2007 Scientific Communications International Limited.