title: Acanthamoeba keratitis after photorefractive keratectomy.
abstract: A 37-year-old women developed severe suppurative keratitis immediately after having photorefractive keratectomy in her left eye. The keratitis was unresponsive to intensive topical antibiotic agents and topical and systemic steroids. Although the differential diagnosis included nonmicrobial and fungal keratitis, the clinical course and confocal microscopy suggested, and subsequent histopathologic examination confirmed, a diagnosis of Acanthamoeba keratitis. The amebic contamination probably resulted from exposure of the deepithelialized cornea to contaminated freshwater in a northern Wisconsin marsh. This case emphasizes the importance of encouraging patients with epithelial defects and bandage soft contact lenses to avoid exposure to contaminated freshwater until reepithelialization is complete.
authors.affiliation: Cornea and External Disease Division, Department of Ophthalmology, Boston University Medical Center, Boston, Massachusetts, USA. Rogerkaldawy@bmc.org
authors.forename: Roger M
authors.initials: RM
authors.lastname: Kaldawy
authors.forename: John E
authors.initials: JE
authors.lastname: Sutphin
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wagoner
mesh_terms: D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003315:Cornea / Q000469:parasitology* / Q000473:pathology; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D054018:Lasers, Excimer; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D014867:Water / Q000469:parasitology
chemical_list: D000981:Antiprotozoal Agents; D014867:Water