title: An atypical presentation of Acanthamoeba keratitis in a noncontact lens wearer.
abstract: This article presents the case of a 49-year-old man who did not have a history of wearing contact lenses and who developed a rapidly progressive course of Acanthamoeba keratitis. The patient developed stromal keratitis that did not respond to herpes simplex virus therapies. Within 1 week after presentation, the patient progressed from mild anterior stromal haze and edema to a ring infiltrate, epithelial loss, and significant corneal edema. Corneal scrapings demonstrated cysts consistent with Acanthanmoeba keratitis. The patient was admitted to the hospital and placed on intensive medical therapy. He responded to therapy, and at 5 months showed central scarring in a quiet eye. This article presents a case of Acanthamoeba keratitis in a non-contact lens wearer, who was diagnosed clinically and histopathologically within 1 week of onset of symptoms. His case was atypical given his lack of contact lens wear or antecedent trauma and rapid progression to a ring infiltrate, usually seen as late findings.
authors.affiliation: Cornea Service, Wills Eye Hospital, Philadelphia, PA 19107, USA.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Speer
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Hofmeister
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Cohen
mesh_terms: D000048:Acanthamoeba / Q000187:drug effects / Q000302:isolation & purification*; D015823:Acanthamoeba Keratitis / Q000175:diagnosis* / Q000188:drug therapy; D000563:Amebicides / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001550:Benzamidines / Q000627:therapeutic use; D003261:Contact Lenses; D003319:Corneal Stroma / Q000469:parasitology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000563:Amebicides; D000900:Anti-Bacterial Agents; D001550:Benzamidines; C005555:propamidine; D009355:Neomycin