Acanthamoeba keratitis due to genotype T11 in a rigid gas permeable contact lens wearer in Spain.
A case of a 59-year-old Spanish patient who presented with severe ocular pain, blurred vision, eyelid swelling and foreign body sensation in the right eye is reported. She was a regular gas permeable contact lens [corrected] wearer who initially claimed to maintain standard lens care. After exploration, conjunctival injection, dendritiform corneal ulcers and stromal edema were observed. She was initially treated for a possible viral keratitis due to herpes simplex virus using 3% topical acyclovir and 0.1% dexamethasone eye drops 5 times a day. The patient did not respond to this treatment and six weeks later, corneal scrapings were positive for Acanthamoeba genotype T11. She was then treated with chlorhexidine 0.02%, propamidine 0.1% and 1% cycloplegic eye drops hourly which resulted in a significant improvement. After a month, ocular pain decreased and the clinical signs of keratitis ameliorated observed as a diminution of the size of the ulcer and also in the extension and opacity of the corneal infiltrates. The patient has been following this treatment for 3 months and it is possible that she will have to carry on with it for a whole year. To the best of our knowledge, this is the first case of severe keratitis due to Acanthamoeba genotype T11 in Spain .
University Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, Tenerife, Canary Islands, Spain.
Jacob
J
Lorenzo-Morales
Rafael
R
Morcillo-Laiz
Carmen Ma
CM
Martín-Navarro
Rogelio
R
López-Vélez
Atteneri
A
López-Arencibia
Francisco
F
Arnalich-Montiel
Sutherland K
SK
Maciver
Basilio
B
Valladares
Enrique
E
Martínez-Carretero
D000048:Acanthamoeba / Q000235:genetics* / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001550:Benzamidines / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use*; D003263:Contact Lenses, Hydrophilic / Q000469:parasitology*; D003315:Cornea / Q000187:drug effects / Q000469:parasitology* / Q000473:pathology; D016054:DNA, Protozoan / Q000032:analysis; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013030:Spain
D000891:Anti-Infective Agents, Local; D000981:Antiprotozoal Agents; D001550:Benzamidines; D016054:DNA, Protozoan; C046651:propamidine isethionate; D002710:Chlorhexidine