title: Acanthamoeba keratitis in a 5-year-old boy without a history of contact lens usage.
abstract: 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 At the end of 5 months, all medications were withdrawn and amblyopia treatment was started.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.
authors.affiliation: Ophthalmology Department, Medical Faculty of Kocaeli University, Kocaeli, Turkey. demirci.g@superonline.com
authors.forename: Göktuğ
authors.initials: G
authors.lastname: Demirci
authors.forename: Gülten Manav
authors.initials: GM
authors.lastname: Ay
authors.forename: Levent V
authors.initials: LV
authors.lastname: Karabas
authors.forename: Ozgül
authors.initials: O
authors.lastname: Altintas
authors.forename: Gülden S
authors.initials: GS
authors.lastname: Tamer
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Cağlar
mesh_terms: 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
chemical_list: D000981:Antiprotozoal Agents; D001550:Benzamidines; D005938:Glucocorticoids; C018961:hexamidine; C009935:prednisolone acetate; D011239:Prednisolone; D002710:Chlorhexidine; D007654:Ketoconazole