棘阿米巴角膜炎
医学
隐形眼镜
棘阿米巴
背景(考古学)
角膜炎
眼科
外科
角膜
皮肤病科
真菌性角膜炎
病理
作者
Bansri K. Lakhani,Bushra Thajudeen,Imran Jawaid,Michelle S. Attzs,Veerabahu S. Maharajan
出处
期刊:Cornea
[Ovid Technologies (Wolters Kluwer)]
日期:2021-06-01
卷期号:40 (6): 769-773
被引量:1
标识
DOI:10.1097/ico.0000000000002491
摘要
To report endotheliitis as an early, key presenting sign of Acanthamoeba keratitis in patients who are soft contact lens wearers.We report 4 cases of patients presenting with pain, red eye, and reduction in vision in the context of soft contact lens wear. On examination, the predominant clinical finding was that of endotheliitis, localized fusiform stromal edema with corresponding keratic precipitates, anterior chamber inflammation, and minimal epithelial and anterior stromal signs. The classical signs of Acanthamoeba keratitis were not present.All 4 cases were clinically diagnosed as Acanthamoeba endotheliitis; corneal scrapes were negative; case 1 was polymerase chain reaction positive, and case 3 underwent confocal microscopy that showed double-walled cysts, suggesting Acanthamoeba. All responded well to anti-Acanthamoeba medication alone with 3 cases achieving complete resolution with minimal anterior stromal scarring by 7 weeks. Case 1 had steroid treatment before being seen at our unit and had a prolonged course of treatment with complete resolution by 4 months.It is imperative to have a high index of suspicion for Acanthamoeba in patients presenting with pain and endotheliitis in the context of contact lens wear, even in the absence of classical signs.
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