Drug-resistant severe Acanthamoeba keratitis caused by rare T5 Acanthamoeba genotype.
OBJECTIVE
To describe a case of severe and drug-resistant Acanthamoeba keratitis in a contact lens wearer caused by atypical T5 Acanthamoeba genotype (Acanthamoeba lenticulata).


METHODS
Report of a case, Acanthamoeba DNA amplification and sequencing.


RESULTS
A 61-year-old patient was referred to our clinic with a 2-week history of keratitis. Acanthamoeba keratitis (AK) was diagnosed using confocal microscopy and corneal scraping culture. Using polymerase chain reaction (PCR) and DNA sequencing, the organism was classified as a T5 genotype (A. lenticulata). The keratitis continued to progress despite topical antiamoebic therapy and ultimately led to enucleation of the affected eye.


CONCLUSIONS
T5 genotype Acanthamoeba can cause severe AK. Atypical Acanthamoeba genotypes could be associated with worse prognosis and resistance to therapy.
Iovieno
Alfonso
A
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami-Miller School of Medicine, Miami, FL 33136, USA. alfonsoiovieno@hotmail.com
Oechsler
Rafael A
RA
Ledee
Dolena R
DR
Miller
Darlene
D
Alfonso
Eduardo C
EC
D000048:Acanthamoeba / Q000187:drug effects* / Q000235:genetics*; D015823:Acanthamoeba Keratitis / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D000563:Amebicides / Q000627:therapeutic use*; D001550:Benzamidines / Q000627:therapeutic use*; D004351:Drug Resistance; D015353:Eye Enucleation; D005260:Female; D005838:Genotype; D006801:Humans; D018613:Microscopy, Confocal; D008875:Middle Aged; D012720:Severity of Illness Index
D000563:Amebicides; D001550:Benzamidines; C005555:propamidine