Acanthamoeba keratitis in a 5-year-old boy without a history of contact lens usage.
OBJECTIVE
This study was designed to report a case of acanthamoeba keratitis in a 5-year-old child without a history of trauma or contact lens usage.


METHODS
The history, clinical presentation, diagnostic, and therapeutic approaches were reviewed.


RESULTS
A 5-year-old child without any history of trauma or contact lens use was referred to our university clinic with an initial diagnosis of disciform herpetic keratitis. After 2 weeks of antibacterial and antiviral therapy, a corneal biopsy was performed for diagnostic purposes. The biopsy revealed acanthamoeba. Subsequently intensive therapy with chlorhexidine diacetate 0.02%, ketoconazole tb, hexamidine di-isethionate 0.1% was initiated. At the end of the first month, topical prednisolone acetate 1% was added to reduce inflammation, Chlorhexidine diacetate 0.02% and oral ketoconazole were discontinued, and hexamidine di-isethionate 0.1% was lowered to 4 x 1 and was administered for an additional 4 months. At the end of 5 months, all medications were withdrawn and amblyopia treatment was started.


CONCLUSIONS
When dealing with keratitis in children, acanthamoeba should be considered even without history of contact lens usage or trauma.
Demirci
Göktuğ
G
Ophthalmology Department, Medical Faculty of Kocaeli University, Kocaeli, Turkey. demirci.g@superonline.com
Ay
Gülten Manav
GM
Karabas
Levent V
LV
Altintas
Ozgül
O
Tamer
Gülden S
GS
Cağlar
Yusuf
Y
D000048:Acanthamoeba / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001550:Benzamidines / Q000627:therapeutic use; D002675:Child, Preschool; D002710:Chlorhexidine / Q000627:therapeutic use; D003261:Contact Lenses / Q000706:statistics & numerical data; D003315:Cornea / Q000469:parasitology; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use
D000981:Antiprotozoal Agents; D001550:Benzamidines; D005938:Glucocorticoids; C018961:hexamidine; C009935:prednisolone acetate; D011239:Prednisolone; D002710:Chlorhexidine; D007654:Ketoconazole