Acanthamoeba keratitis; report of the first Norwegian cases

Two patients with therapy resistant keratitis are described. There were no predisposing diseases. Both patients had been using rigid contact lenses for more than 10 years and both cleaned their lenses in cold tap water. The patients presented with keratitis of several weeks duration resistant to antibacterial and antiviral treatment and not responding to high doses of corticosteroids. Ultimately, after the possibility of a protozoan aetiology had been considered, culture of corneal scrapings from both patients yielded growth of Acanthamoeba trophozoites. Acanthamoeba keratitis is very rare in northern European countries and has never before been diagnosed in Norway. The present cases show that Acanthamoeba should be added to the list of possible pathogenic agents even in northern low temperature areas.