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Related Experiment Videos

Arthrographis keratitis mimicking acanthamoeba keratitis.

Seth A Biser1, Henry D Perry, Eric D Donnenfeld

  • 1Hudson Valley Eye Surgeons, Fishkill, NY, USA.

Cornea
|April 16, 2004
PubMed
Summary

This case report details a rare fungal keratitis caused by Arthrographis kalrae in a contact lens wearer. The infection mimicked Acanthamoeba keratitis, highlighting diagnostic challenges in fungal eye infections.

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Area of Science:

  • Ophthalmology
  • Medical Mycology
  • Infectious Diseases

Background:

  • Fungal keratitis is a significant cause of ocular morbidity, particularly in contact lens wearers.
  • Arthrographis kalrae is a rare fungal pathogen, with limited reported cases of ocular infection.
  • Differentiating fungal keratitis from other microbial keratitis, such as Acanthamoeba keratitis, is crucial for effective treatment.

Observation:

  • A 23-year-old female contact lens wearer presented with dendritic keratitis, initially treated as viral infection.
  • The keratitis evolved into a ring-shaped stromal haze, with symptoms mimicking Acanthamoeba keratitis.
  • Empiric treatment for Acanthamoeba was ineffective, prompting further investigation.

Findings:

  • Cultures eventually identified Arthrographis kalrae as the causative agent of keratitis.

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  • Treatment with amphotericin B resulted in resolution of the fungal keratitis.
  • The patient's vision improved from 20/200 to 20/100 with antifungal therapy.

    • Implications:

    • This case underscores the importance of considering rare fungal pathogens in refractory keratitis cases.
    • Arthrographis kalrae can present with clinical features similar to Acanthamoeba keratitis, posing diagnostic challenges.
    • Early and accurate diagnosis of fungal keratitis is essential to prevent vision loss and improve patient outcomes.