title: Microbiological profiles of fungal keratitis: a 10-year study at a tertiary referral center.
abstract: BACKGROUND
  Given the rise in cases of fungal keratitis in recent years, this study was performed to better elucidate the microbiological profile, risk factors, and surgical intervention rates of fungal keratitis at a tertiary referral center in the Southeastern USA.
  
  
  RESULTS
  This is a retrospective case series of fungal keratitis infections treated at Duke University Eye Center from January 1, 1998, to October 6, 2008. Of the 4651 culture-proven corneal ulcers identified, 63 (1.4 %) were positive for fungal keratitis with a total of 69 fungal organisms isolated. The majority of isolates were filamentous species (44 of 69, 64 %), and the most commonly isolated organism was Curvularia (11 of 69, 16 %). Bacterial coinfections were found in 24 of the 63 cases (38 %). The most commonly associated risk factors were contact lens wear (n = 15, 24 %) and prior penetrating keratoplasty (PKP) (n = 15, 24 %). Twenty-three cases (37 %) required surgical intervention. The rate of surgical intervention was highest in patients with prior PKP (7/15, 47 %).
  
  
  CONCLUSIONS
  In this study, the leading risk factors for fungal keratitis were contact lens wear and prior PKP. Filamentous species were the most common causative pathogens. A relatively high rate of mixed bacterial-fungal infections was found. Patients with prior PKP were more likely to require surgery than patients without history of keratoplasties.
authors.affiliation: Shiley Eye Institute, University of California San Diego, San Diego, CA, USA. jwh009@ucsd.edu.
authors.forename: Joanne W
authors.initials: JW
authors.lastname: Ho
authors.affiliation: Duke Eye Center, Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA. mark.fernandez@gmail.com.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Fernandez
authors.affiliation: Duke Eye Center, Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA. rachelle.rebong@gmail.com.
authors.forename: Rachelle A
authors.initials: RA
authors.lastname: Rebong
authors.affiliation: Duke Eye Center, Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA. alan.carlson@duke.edu.
authors.forename: Alan N
authors.initials: AN
authors.lastname: Carlson
authors.affiliation: Duke Eye Center, Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA. terry.kim@duke.edu.
authors.forename: Terry
authors.initials: T
authors.lastname: Kim
authors.affiliation: Shiley Eye Institute, University of California San Diego, San Diego, CA, USA. DrAfshari@ucsd.edu.|Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr. #0946, La Jolla, CA, 92093-0946, USA. DrAfshari@ucsd.edu.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Afshari
keywords: Contact lens; Cornea; Fungal keratitis; Microbiology; Penetrating keratoplasty