1/51. Acanthamoeba as a cause of peripheral ulcerative keratitis.PURPOSE: To report a case of peripheral ulcerative keratitis caused by Acanthamoeba. methods: Case report and review of the literature. A 37-year-old woman with a history of pain and redness of the right eye with no apparent predisposing factors, on examination, revealed a peripheral ulcerative keratitis. RESULT: Microbiological investigations of the corneal infiltrate revealed Acanthamoeba cysts. CONCLUSION: All cases of peripheral ulcerative keratitis should be subjected to routine microbiological evaluation including those for Acanthamoeba.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
2/51. Disseminated Acanthamoeba sinusitis in a patient with AIDS: a possible role for early antiretroviral therapy.Acanthamoeba, a free-living ameba, has been reported to infect humans with subacute encephalitis, sinusitis, or keratitis. Multiple cases of Acanthamoeba sinusitis with dissemination have been reported in association with AIDS, with high mortality. We report successful treatment of a 35-year-old woman who presented with sinusitis that progressed to disseminated acanthamebiasis as her initial manifestation of AIDS. To our knowledge, our patient was one of the few and longest-lived survivors of disseminated Acanthamoeba infection with AIDS. As with other opportunistic infections, early aggressive therapy including HAART may alter the outcome in this almost uniformly fatal disease.- - - - - - - - - - ranking = 0.14285714285714keywords = keratitis (Clic here for more details about this article) |
3/51. Disseminated cutaneous acanthamebiasis: a case report and review of the literature.The genus Acanthamoeba includes species of free-living soil and water ameba that have been implicated in a small number of human diseases. Acanthamoeba species have been identified as the etiologic agents in 2 well-defined clinical entities, amebic keratitis and granulomatous amebic encephalitis (GAE). Less commonly, Acanthamoeba species have been identified as the cause of disseminated disease in debilitated and immunocompromised patients. Cutaneous acanthamebiasis, often a reflection of disseminated disease, is an increasingly recognized infection since the emergence of acquired immunodeficiency syndrome (AIDS) and the use of immunosuppressive drugs. The disease portends a poor prognosis and is uniformly fatal if the infection involves the central nervous system (CNS). We describe a patient with advanced AIDS who presented with disseminated cutaneous lesions, headache, and photophobia, and in whom a diagnosis of cutaneous acanthamebiasis was made based on the results of a skin biopsy. A multidrug therapeutic regimen was begun that included sulfadiazine; the patient responded favorably to treatment. This paper also reviews 36 previously reported cases of cutaneous acanthamebiasis with delineation of clinical, diagnostic, histologic, and prognostic features, as well as discusses treatment options.- - - - - - - - - - ranking = 0.14285714285714keywords = keratitis (Clic here for more details about this article) |
4/51. Acanthamoeba infection as a cause of severe keratitis in a soft contact lens wearer in jamaica.We report the case of a 29-year-old Jamaican patient who presented with severe pain, redness, and swelling of both eyes. She was a regular soft contact lens wearer who did not maintain standard lens care. She was treated for a possible microbial/viral keratitis using topical ciprofloxacin drops, topical acyclovir ointment, and topical atropine drops. The response was inadequate, and scrapings from her cornea, contact lens cases, and both lenses revealed Acanthamoeba on microscopy, which was shown to be Acanthamoeba polyphaga using polymerase chain reaction. She was treated using chlorhexidine 0.02% hourly, ciprofloxacin every 4 hours, and atropine 1% every 12 hours, along with oral ketoconazole 200 mg twice daily with a dramatic response. However, she subsequently suffered slow corneal epithelial regrowth with severe scarring, vascularization, and cortical lens opacification and was referred for penetrating keratoplasty and cataract surgery. This is the first case of severe keratitis caused by Acanthamoeba to be reported from jamaica and demonstrates that this emerging pathogen can be a cause of severe keratitis in the tropics.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
5/51. Successful medical management of acanthamoeba keratitis.Seven patients with documented acanthamoeba keratitis were treated with prolonged and intensive triple antiamoebic therapy consisting of topical neomycin-polymyxin b-gramicidin, propamidine isethionate 0.1%, and miconazole nitrate 1%. Additionally, five patients were treated with topical corticosteroids. Six of seven patients were cured of acanthamoeba keratitis with medical therapy alone, one patient required therapeutic penetrating keratoplasty to eradicate the infection. Two patients underwent penetrating keratoplasty to improve their vision after medical therapy. Our series differs from previous reports in that triple antiamoebic therapy was used in all seven patients and was successful in both early and advanced cases of acanthamoeba keratitis. Prolonged and intensive topical therapy with these three antiamoebic drugs may be an effective mode of therapy for acanthamoeba keratitis.- - - - - - - - - - ranking = 1.1428571428571keywords = keratitis (Clic here for more details about this article) |
6/51. acanthamoeba keratitis associated with disposable contact lenses.Two patients developed acanthamoeba keratitis associated with the use of disposable extended-wear hydrogel contact lenses. Both patients removed, irrigated, and reinserted the contact lenses without disinfecting them. One patient wore the lenses on a daily basis, rinsed the lenses in tap water, stored them overnight, and discarded them weekly. Both infections were treated successfully. In a third patient, Acanthamoeba species was cultured from two pairs of disposable lenses that had been stored in cases rinsed with well water. Potential benefits from disposable contact lens wear are negated when patients do not comply with a continuous wearing schedule.- - - - - - - - - - ranking = 0.71428571428571keywords = keratitis (Clic here for more details about this article) |
7/51. Rapid diagnosis of acanthamoeba keratitis using calcofluor white.Calcofluor white (CFW) is a chemofluorescent dye with an affinity for the polysaccharide polymers of amebic cysts. Using CFW staining with fluorescent microscopy, we demonstrated amebic cysts in corneal scrapings and keratectomy specimens from four patients with culture-proved acanthamoeba keratitis and from one in whom CFW was the only positive laboratory test. Calcofluor white staining is simple, rapid, and highly reliable in the diagnosis of acanthamoeba keratitis.- - - - - - - - - - ranking = 0.85714285714286keywords = keratitis (Clic here for more details about this article) |
8/51. Rapid diagnosis of acanthamoeba keratitis from corneal scrapings using indirect fluorescent antibody staining.Two soft contact lens wearers using a homemade saline solution developed corneal stromal inflammation and epithelial ulceration and were both treated for months with a presumptive diagnosis of herpes simplex keratitis. Subsequently, corneal scrapings revealed refractile, cystic structures consistent with the appearance of Acanthamoeba. This was rapidly confirmed by indirect fluorescent antibody studies, and Acanthamoeba castellani was later identified by growth in culture in both cases. Acanthamoeba is being reported with increasing frequency as a pathogen responsible for chronic stromal keratitis and ulceration in contact lens wearers. Since specific therapy is required to control this organism, rapid diagnosis is essential. Indirect fluorescent antibody staining of corneal scrapings provides a simple means of accomplishing this goal with a high degree of accuracy.- - - - - - - - - - ranking = 0.85714285714286keywords = keratitis (Clic here for more details about this article) |
9/51. Unsuspected infectious keratitis in host corneal buttons.Infectious keratitis may be unsuspected preoperatively in patients undergoing penetrating keratoplasty. We have diagnosed five cases of previously unknown corneal infection discovered only after post-keratoplasty histopathologic examination using specific stains. These cases of preoperatively unsuspected infectious keratitis illustrate examples where histopathologic examination using specialized stains may alert the physician to the need for appropriate postoperative antimicrobial therapy. Furthermore, these cases illustrate the ability of soft contact lenses to mask symptoms of infectious keratitis. Additionally, the clinical appearance of advanced bullous keratopathy may mask signs of infectious keratitis.- - - - - - - - - - ranking = 1.1428571428571keywords = keratitis (Clic here for more details about this article) |
10/51. acanthamoeba keratitis associated with contact lenses: six consecutive cases of successful management.We examined and treated six patients with acanthamoeba keratitis associated with contact lens wear from 1981 to 1988. Five patients were treated with topical neomycin-polymyxin b-gramicidin (Neosporin) and propamidine isethionate (Brolene) drops. The patients were followed up for an average of 32 months (range 16-75 months). Two patients underwent penetrating keratoplasty at 22 and 26 months after the onset of symptoms and have maintained clear grafts with no evidence of recurrence. In four patients corneal infiltrates cleared on topical medication. All six patients have 6/6 best corrected vision. early diagnosis and medical treatment alone can result in resolution of corneal infiltrates due to acanthamoebae. With this initial therapy we have had no treatment failures.- - - - - - - - - - ranking = 0.71428571428571keywords = keratitis (Clic here for more details about this article) |
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