ABSTRACT
Background: The incidence of infectious keratitis has risen inthe last decade, partially due to an increasing number ofcontact lens users and immune-compromised patients. Hence;the present study was undertaken for assess themicrobiological profile of patients with infection keratitis.Materials & Methods: A total of 96 patients of infectionkeratitis were enrolled in the present study. Completedemographic and clinical details of all the patients wereobtained. Slit-lamp biomicroscope examination of all thepatients was done. This was followed by collection of cornealscrapings under septic conditions by experienced and skilledophthalmologist. Inoculation of the material directly on the solidmedia was done. The media used were blood agar, chocolateagar and Sabouraud dextrose agar (SDA). Overnightincubation of seeded media was done. Assessment of cultureand colonies was done by skilled and experiencedmicrobiologists.Results: Only bacterial isolates were found to be present in54.2 percent of the patients. Only fungal isolates were foundto be 39.6 percent of the patients. Mixed infection wasfound to be present in 6.2 percent of the patients. Fusarium,Aspergillus, Hyalohyphomycetes, Curvularia and Candida werethe most common fungal species encountered. S.aureus,S.pneumoniae, Pseudomonas aeruginosa and Klebsiellapneumonia were the most common bacterial speciesencountered.Conclusion: Infection keratitis comprises of mixed spectrum ofbacteria and fungi.
ABSTRACT
Background: Some patients report hypersensitivity reactions to many drugs making it difficult to prescribe medications when they fall ill. Aim: To describe the clinical profile of multiple drug hypersensitivity and the results of challenge testing in a large teaching hospital.Methods: We performed a five-year retrospective review of the records of patients who complained of reactions to two or more unrelated drugs and avoided medication because of a fear of developing reactions. Oral challenge testing was carried out in hospital with drugs suspected by the patient to cause reactions and/or commonly prescribed medications. A positive reaction was diagnosed when symptoms and signs resembled previously experienced episodes and there was no such reaction with placebo. Results: Twenty three patients (aged 14-65 years; 19 females) underwent challenge testing. Their complaints had been present for 1-30 years, with 2-40 drug reaction episodes reported. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) were most commonly implicated, and urticaria/angioedema were the most often reported manifestations. The patients underwent 3-27 challenges with 1-24 drugs. Three had positive challenge reactions with various NSAIDs, 13 developed symptoms and signs that were judged not to be true reactions, and 7 had no reactions. None of our patients qualified for a diagnosis of true multiple drug hypersensitivity. Conclusion: Patients who believe they are allergic to multiple, pharmacologically unrelated drugs are usually mistaken. Challenge testing is a reliable way of demonstrating this and providing patients with a list of safe drugs.