Last update:
12-Jun-2001

Arch Hellen Med, 17(6), November-December 2000, 615-619

SHORT COMMUNICATION

Acanthamoeba keratitis in non-contact lens wearers

K. TZANETOU,¹ D. MILTSAKAKIS,² S. ALIMISI,² E. DOLAPSAKI,¹
E. MICHAELIDOU,¹ E. LAMBRINIDOU,¹ E. MALAMOU-LADA^1
1Laboratory of Microbiology,
²Department of Ophthalmology, "G. Gennimatas" District General Hospital of Athens, Athens, Greece

This is a report of 2 cases of culture-proven Acanthamoeba keratitis, in non-wearers of contact-lenses, diagnosed during the last 5 years. Both patients presented with symptoms and signs of advanced infection, of at least one month’s duration. The first patient presented with a ring- shaped stromal infiltrate and had a history of corneal trauma from a tree branch. The second was a seaman with a central round infiltration who had a history of daily exposure to contaminated reservoir water. Acanthamoeba was isolated from biopsy material and corneal scrapings by culture on non-nutrient agar overlaid with Escherichia coli, as well as from the reservoir water in the second case. Topical therapy (a combination of Brolene 0.1% and Neosporine or Chloredixine 0.02% and Desomedine 0.1%) failed, because of delayed diagnosis and treatment initiation, and both patients subsequently underwent penetrating keratoplasty. In conclusion, non-wearers of contact-lenses with symptoms of keratitis and a history of exposure to one of the known risk factors (trauma, contact with contaminated water) should also be investigated for Acanthamoeba infection, so that early diagnosis investigated and initiation of effective treatment can be ensured.

Key words: Acanthamoeba, Keratitis, Non-wearers of contact lenses.