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Related Experiment Videos

Endogenous amoebic endophthalmitis.

T Matsuo1, K Notohara, F Shiraga

  • 1Department of Ophthalmology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama City 700-8558, Japan. matsuot@cc.okayama-u.ac.jp

Archives of Ophthalmology (Chicago, Ill. : 1960)
|February 7, 2001
PubMed
Summary

Acanthamoeba keratitis (AK) can cause vision loss. Early vitrectomy and combined antibiotic/antifungal treatment led to a good visual outcome in a patient with AK and bacterial co-infection.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Acanthamoeba keratitis (AK) is a serious ocular infection that can lead to vision impairment.
  • Prompt diagnosis and treatment are crucial for managing AK and preventing vision loss.

Observation:

  • A 42-year-old male presented with sudden vision reduction in the left eye, exhibiting vitreous opacity and hypopyon.
  • Microscopic examination of aqueous humor and vitreous fluid revealed amoebas with characteristic crescent-shaped cytoplasm and ambiguous nuclei, alongside polymorphonuclear cells.
  • Staphylococcus epidermidis was also isolated from the vitreous fluid, indicating a co-infection.

Findings:

  • The amoebas possessed a unique ultrastructural feature: a thick electron-dense coating surrounding the cytoplasm.

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  • The patient underwent emergency pars plana vitrectomy, phacoemulsification, and posterior capsulectomy.
  • A 2-week course of intravenous fluconazole and antibiotics was administered post-operatively.

    • Implications:

    • The combination of early surgical intervention (vitrectomy) and a dual antimicrobial approach (antibiotics and antifungals) may be key to achieving favorable visual outcomes in complex AK cases.
    • This case highlights the importance of identifying and treating both amoebic and bacterial co-infections in severe ocular infections.