title: ACANTHAMOEBA ENDOPHTHALMITIS AFTER RECURRENT KERATITIS AND NODULAR SCLERITIS.
abstract: OBJECTIVE
  To describe the clinical course of a patient with Acanthamoeba keratitis, who despite prompt treatment progressed to histopathology-confirmed Acanthamoeba retinitis and endophthalmitis.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A healthy 30-year-old male wearing soft contact lens was diagnosed with Acanthamoeba keratitis and treated medically and surgically over the course of 1 year with presumed resolution of the infection. Yet, his infection recurred with documented spread to sclerokeratitis, and overwhelming endophthalmitis. Concerns about extra-ocular spread prompted a therapeutic enucleation with histopathologic evidence of Acanthamoeba organisms throughout the globe.
  
  
  CONCLUSIONS
  This is a case of a severe recurrent Acanthamoeba infection presenting initially as keratitis, followed by sclerokeratitis and histolopathology-confirmed endophthalmitis. This case demonstrates that despite persistent medical and surgical intervention, eradication of organisms may not be possible.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada; †VitreoRetinal Surgery, PA, Minneapolis, Minnesota; ‡Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa city, Iowa; and §Department of Ophthalmology, Omics Laboratory, Iowa City, Iowa.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Mammo
authors.forename: David R P
authors.initials: DR
authors.lastname: Almeida
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Cunningham
authors.forename: Eric K
authors.initials: EK
authors.lastname: Chin
authors.forename: Vinit B
authors.initials: VB
authors.lastname: Mahajan
mesh_terms: D015823:Acanthamoeba Keratitis / Q000473:pathology*; D000328:Adult; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects; D018450:Disease Progression; D009877:Endophthalmitis / Q000469:parasitology*; D006801:Humans; D008297:Male; D012173:Retinitis / Q000469:parasitology*; D015423:Scleritis / Q000469:parasitology*