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Coexistent Acanthamoeba keratitis and herpetic keratitis
W D Mathers1, M A Goldberg, J E Sutphin
1Department of Ophthalmology, University of Iowa, Iowa City, USA.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|June 1, 1997
Summary
Acanthamoeba keratitis can occur alongside herpes simplex virus keratitis (herpetic keratitis). This opportunistic infection highlights the importance of considering Acanthamoeba in patients with herpetic keratitis.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Herpes simplex virus keratitis (herpetic keratitis) is a common cause of corneal blindness.
- Acanthamoeba keratitis is a severe microbial keratitis, often associated with contact lens wear.
Observation:
- This study describes patients with confirmed herpetic keratitis who also developed Acanthamoeba keratitis.
- Diagnostic methods included viral cultures, immunologic stains, and histopathology for herpetic keratitis.
- Acanthamoeba was identified via confocal microscopy and epithelial biopsy.
Findings:
- Herpes simplex virus was confirmed in 8 out of 9 patients.
- Acanthamoeba was detected in 8 out of 9 patients using confocal microscopy and/or biopsy.
- Two patients with co-infection reported a history of contact lens use.
Implications:
- Acanthamoeba keratitis can present as a secondary or opportunistic infection in patients with herpetic keratitis.
- Clinicians should maintain a high index of suspicion for Acanthamoeba keratitis in patients with herpetic keratitis, especially contact lens wearers.
- This co-infection may complicate treatment and impact visual outcomes.