A Case of Keratitis Due to Acanthamoeba in New York, New York, and Features of 10 Cases

A man in New York, New York, contracted keratitis caused by Acanthamoeba castellanii. The diagnosis was delayed because amoebae were not initially suspected as the infectious organism. The culture isolate and the amoebae in corneal sections were identified as A. castellanii by immunofluorescence usi...

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Bibliographic Details
Published in:The Journal of infectious diseases 1981-05, Vol.143 (5), p.662-667
Main Authors: Ma, Pearl, Willaert, Eddy, Juechter, Kenneth B., Stevens, Ann R.
Format: Article
Language:English
Subjects:
Adult
Aged
Amoeba
Amoeba - pathogenicity
Animals
Atropine - therapeutic use
Biopsies
Clinical Syndromes
Corneal transplantation
Cysts
Dexamethasone - therapeutic use
Eyes
Female
Humans
Infections
Inoculation
Keratitis
Keratitis - epidemiology
Keratitis - etiology
Keratitis - pathology
Male
Mice
Microbial Sensitivity Tests
Middle Aged
Natamycin - therapeutic use
Neomycin - therapeutic use
New York City
Rifampin - therapeutic use
Trophozoites
Uracil - analogs & derivatives
Uracil - therapeutic use
Virulence
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Summary:A man in New York, New York, contracted keratitis caused by Acanthamoeba castellanii. The diagnosis was delayed because amoebae were not initially suspected as the infectious organism. The culture isolate and the amoebae in corneal sections were identified as A. castellanii by immunofluorescence using antiserum to plasma membranes of this species. With the rapid agar disk diffusion method, the amoebae were shown to be susceptible to pimaricin (0.5%) and resistant to >1,000/μg/ml levels of paromomycin, polymyxin B-bacitracin-neomycin, acriflavine, 5-fluorocytosine, amphotericin B, gentamicin, and trimethoprim-sulfamethoxazole. The infection responded to treatment with pimaricin administered with several other drugs. This infection is the eighth case reported in the literature of acanthamoebic keratitis and emphasizes the need for clinicians to consider acanthamoebic infection in the differential diagnosis of eye infections that fail to respond to bacterial, fungal, and viral therapy.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/143.5.662