title: Co-isolation of Vahlkampfia and acanthamoeba in acanthamoeba-like keratitis in a Spanish population.
abstract: OBJECTIVE
  To report the co-isolation incidence of Acanthamoeba and Vahlkampfia in amoebic keratitis from a tertiary care institution in Madrid, Spain.
  
  
  METHODS
  In this retrospective case series, 7 eyes of 7 consecutive patients with culture-proven or polymerase chain reaction-positive Acanthamoeba keratitis were seen at a tertiary care institution from January 2010 to April 2011, and their charts were reviewed.
  
  
  RESULTS
  Two of 7 patients showed mixed Acanthamoeba and Vahlkampfia keratitis. Good clinical response to the treatment was strongly correlated with early diagnosis, whereas delayed diagnosis resulted in poor response to the treatment in single or mixed infection.
  
  
  CONCLUSIONS
  Co-isolation of Vahlkampfia and Acanthamoeba in Acanthamoeba-like keratitis has recently been detected in our population. This finding should raise awareness of the existence of other amoeba different from Acanthamoeba causing keratitis. There are not enough cases yet to determine the impact of mixed amoebic keratitis in the prognosis of this disease.
authors.affiliation: Cornea Unit, Ophthalmology Department, Ramón y Cajal Hospital, Madrid, Spain. farnalich@gmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Arnalich-Montiel
authors.forename: Jacob
authors.initials: J
authors.lastname: Lorenzo-Morales
authors.forename: Cristina
authors.initials: C
authors.lastname: Irigoyen
authors.forename: Rafael
authors.initials: R
authors.lastname: Morcillo-Laiz
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
authors.forename: Francisco
authors.initials: F
authors.lastname: Muñoz-Negrete
authors.forename: Jose E
authors.initials: JE
authors.lastname: Piñero
authors.forename: Basilio
authors.initials: B
authors.lastname: Valladares
mesh_terms: D000048:Acanthamoeba / Q000235:genetics / Q000302:isolation & purification*; D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001550:Benzamidines / Q000627:therapeutic use; D001645:Biguanides / Q000627:therapeutic use; D002460:Cell Line; D016054:DNA, Protozoan / Q000032:analysis; D004202:Disinfectants / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005784:Gene Amplification; D060005:Genotyping Techniques; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011743:Pyrimidines / Q000627:therapeutic use; D012337:RNA, Ribosomal, 18S / Q000235:genetics; D012189:Retrospective Studies; D016847:Schizopyrenida / Q000235:genetics / Q000302:isolation & purification*; D013030:Spain; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000981:Antiprotozoal Agents; D001550:Benzamidines; D001645:Biguanides; D016054:DNA, Protozoan; D004202:Disinfectants; D011743:Pyrimidines; D012337:RNA, Ribosomal, 18S; D014230:Triazoles; C031233:polihexanide; C005555:propamidine; D065819:Voriconazole