title: An unusual case of Acanthamoeba Polyphaga and Pseudomonas Aeruginosa keratitis.
abstract: A 56-year-old woman with a history of disposable soft contact lens wear was referred to our university eye center for a corneal ulcer. Based on the microbial culture, the initial diagnosis was bacterial keratitis, which was unresponsive to topical fortified antibiotics. The patient was then examined using in vivo confocal microscopy, which revealed Acanthamoeba infection. This case emphasizes the need to suspect Acanthamoeba infection in soft contact lens wearers who present with progressive ulcerative keratitis or progressively worsening corneal ulcers that are not responsive to the usual antimicrobial therapy. It is also important to consider the possibility of a coinfection with bacterial and Acanthamoeba species.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5168343391150859.
authors.forename: Jiaxu
authors.initials: J
authors.lastname: Hong
authors.forename: Jian
authors.initials: J
authors.lastname: Ji
authors.affiliation: Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai 200031, China. jianjiangxu@126.com.
authors.forename: Jianjiang
authors.initials: J
authors.lastname: Xu
authors.forename: Wenjun
authors.initials: W
authors.lastname: Cao
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Liu
authors.forename: Xinghuai
authors.initials: X
authors.lastname: Sun
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D060085:Coinfection; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology / Q000821:virology; D003320:Corneal Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000821:virology; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D005260:Female; D006801:Humans; D008875:Middle Aged; D056686:Mimiviridae / Q000302:isolation & purification*; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*
chemical_list: D000890:Anti-Infective Agents