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Acanthamoeba keratitis with live isolates treated with cryosurgery and fluconazole
1Department of Ophthalmology, Morningside Clinic, Johannesburg, South Africa. percy@icon.co.za
American Journal of Ophthalmology
|June 18, 1999
Summary
Live Acanthamoeba trophozoites were identified in the anterior chamber fluid of a patient with Acanthamoeba keratitis. Combination therapy with oral fluconazole after corneal cryosurgery showed effectiveness.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Acanthamoeba keratitis is a severe corneal infection often leading to vision loss.
- Early diagnosis and effective treatment are crucial for managing Acanthamoeba keratitis.
Observation:
- Live, active Acanthamoeba trophozoites were observed in anterior chamber fluid obtained via transcorneal tap.
- The observed trophozoites exhibited characteristics resembling Acanthamoeba polyphagia.
Findings:
- A combination therapy involving corneal cryosurgery followed by oral fluconazole treatment led to the resolution of Acanthamoeba keratitis.
- The patient's condition resolved after 8 weeks of oral fluconazole therapy.
Implications:
- Transcorneal tap can be a valuable diagnostic method for identifying motile Acanthamoeba in anterior chamber infections.
- Combined therapeutic approaches, including cryosurgery and systemic antifungal agents like fluconazole, may offer a promising strategy for treating recalcitrant Acanthamoeba keratitis.