Arthrographis keratitis mimicking acanthamoeba keratitis.
OBJECTIVE
To describe a case of keratomycosis caused by Arthrographis kalrae, mimicking Acanthamoeba keratitis.


METHODS
Case report.


RESULTS
A 23-year-old female contact lens wearer developed dendritic keratitis in her amblyopic eye (OD). Baseline vision was 20/50. Treatment with trifluridine 1% resulted in resolution of the dendrite, but an area of stromal haze developed, spreading to a discontinuous ring shape, and the vision dropped to 20/200. Photophobia was intense, and pain was out of proportion to the examination. Cultures were sent, and empiric treatment of Acanthamoeba was begun, without subsequent improvement. After 4 weeks, cultures were positive for a fungal species. Amphotericin 0.5% drops were begun, with moderately rapid resolution of the active keratitis. At last follow-up, best-corrected vision was 20/100. Review of the culture showed the organism to be Arthrographis kalrae.


CONCLUSIONS
Arthrographis kalrae has been reported only once before as an ocular pathogen. As in the previously reported case of Arthrographis, our patient's presentation was strongly suggestive of Acanthamoeba keratitis.
Biser
Seth A
SA
Hudson Valley Eye Surgeons, Fishkill, NY, USA.
Perry
Henry D
HD
Donnenfeld
Eric D
ED
Doshi
Sima J
SJ
Chaturvedi
Vishnu
V
D015823:Acanthamoeba Keratitis / Q000175:diagnosis; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D007635:Keratitis, Dendritic / Q000150:complications / Q000188:drug therapy; D003904:Mitosporic Fungi / Q000302:isolation & purification*; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D009883:Ophthalmic Solutions
D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D000666:Amphotericin B