Acanthamoeba keratitis successfully treated with prolonged propamidine isethionate and neomycin-polymyxin-gramicidin.
We report a case of Acanthamoeba castellanii keratitis that was successfully treated with intense propamidine isethionate and neomycin-polymyxin-gramicidin over 11 and nine days, respectively. The frequency with which the medications were applied, once every 30 minutes with each medication, has been surpassed only once before in reported cases. Additional medical treatment included topical miconazole 1% drops for five days and clotrimazole 1% drops for one day; the latter was discontinued due to corneal epithelial toxicity. Intense treatment of Acanthamoeba keratitis with these medications has not been reported before for as long as 11 days. Our aggressive approach was successful, and no clinically detectable significant side effects were observed. There has been no recurrence to date.
Cornea Service, University of Chicago, Pritzker School of Medicine, IL.
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D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000293:Adolescent; D000578:Amidines / Q000627:therapeutic use*; D001550:Benzamidines / Q000627:therapeutic use*; D003261:Contact Lenses / Q000009:adverse effects; D003315:Cornea / Q000469:parasitology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006096:Gramicidin / Q000627:therapeutic use*; D006801:Humans; D008825:Miconazole / Q000627:therapeutic use; D009355:Neomycin / Q000627:therapeutic use*; D011113:Polymyxins / Q000627:therapeutic use*; D014326:Tropanes / Q000627:therapeutic use; D014792:Visual Acuity
D000578:Amidines; D001550:Benzamidines; D011113:Polymyxins; D014326:Tropanes; D006096:Gramicidin; D008825:Miconazole; C046651:propamidine isethionate; C100236:homatropine; D009355:Neomycin