{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:35:35Z","timestamp":1787758535357,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"\n Purpose:<\/jats:title>\n \n To differentiate\n Pythium<\/jats:italic>\n keratitis from fungal keratitis using clinical signs, to explore usefulness of various signs as diagnostic prognosticators, and develop a clinical scoring system.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A retrospective review of medical records and archived clinical photographs of patients with culture-positive\n Pythium<\/jats:italic>\n keratitis and hyaline filamentous fungal keratitis was conducted at a tertiary eye institute to explore characteristics of ulcers that may aid diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Full-thickness corneal stromal keratitis (\n P<\/jats:italic>\n = 0.055), a dry ulcer surface (\n P<\/jats:italic>\n = 0.010), tentacles (\n P<\/jats:italic>\n < 0.0001), intrastromal dots (\n P<\/jats:italic>\n < 0.0001), ring infiltrates (\n P<\/jats:italic>\n = 0.024), reticular patterns (\n P<\/jats:italic>\n < 0.0001), and peripheral furrows (\n P<\/jats:italic>\n < 0.0001) were clinical signs associated with\n Pythium<\/jats:italic>\n keratitis. Multiple regression analysis identified tentacles (odds ratio: 24.1, 95% confidence interval (CI): 3.8\u2013158.1,\n P<\/jats:italic>\n = 0.001) and peripheral furrows (odds ratio: 60.6, 95% CI: 5.1\u2013712.3,\n P<\/jats:italic>\n = 0.001) as independent diagnostic prognosticators for\n Pythium<\/jats:italic>\n keratitis. The positive and negative likelihood ratios of a dry ulcer surface, tentacles, intrastromal dots, ring infiltrates, reticular patterns, and peripheral furrows predicting\n Pythium<\/jats:italic>\n keratitis were 1.6, 13.6, 17.9, 4.3, 30.7, 15.3 and 0.4, 0.4, 0.7, 0.9, 0.6 and 0.8, respectively. The presence of two or more of these clinical signs (excluding a dry ulcer surface) had a sensitivity of 55.6% and a false positive rate of 1.4%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Tentacles, intrastromal dots, ring infiltrates, reticular patterns, and peripheral furrows are clinical signs to be considered for the diagnosis of\n Pythium<\/jats:italic>\n keratitis and the presence of two or more signs has a very low false positive rate.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_870_22","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T11:10:13Z","timestamp":1665054613000},"page":"3515-3521","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Clinical differentiation of Pythium keratitis from fungal keratitis and development of a scoring system"],"prefix":"10.4103","volume":"70","author":[{"given":"Samrat","family":"Chatterjee","sequence":"first","affiliation":[{"name":"Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepshikha","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharad Nivrutti","family":"Gomase","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"B1-20240828","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/00003226-199301000-00015","article-title":"Human infectious corneal ulcer caused by Pythium 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