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Acanthamoeba keratitis and infectious crystalline keratopathy
R M Davis1, R P Schroeder, J J Rowsey
1Department of Ophthalmology, Dean A. McGee Eye Institute, University of Oklahoma, Oklahoma City.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1987
Summary
This study presents two cases of simultaneous Acanthamoeba keratitis and infectious crystalline keratopathy. It highlights the risk of bacterial keratitis, like infectious crystalline keratopathy, after corticosteroid use for Acanthamoeba keratitis.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Acanthamoeba keratitis is a severe corneal infection.
- Infectious crystalline keratopathy (ICK) is a rare form of bacterial keratitis.
- Topical corticosteroids are sometimes used to manage inflammation in keratitis.
Observation:
- Two patients presented with simultaneous Acanthamoeba keratitis and ICK.
- Bacterial cultures revealed alpha-hemolytic Streptococcus viridans after corticosteroid therapy.
- Acanthamoeba species were identified in both cases via culture and staining.
Findings:
- Histopathology confirmed ICK (cocci in stromal lamellae) and Acanthamoeba (double-walled cysts).
- Corticosteroid therapy, initially for presumed herpes simplex keratitis, preceded bacterial superinfection in both cases.
- This suggests a potential link between corticosteroid use and the development of ICK in the context of Acanthamoeba keratitis.
Implications:
- Clinicians should be aware of the risk of secondary bacterial keratitis, including ICK, when using topical corticosteroids in patients with Acanthamoeba keratitis.
- Prompt diagnosis and appropriate antimicrobial therapy are crucial for managing these complex corneal infections.
- Further research is needed to elucidate the precise mechanisms and risk factors involved.