Free-Living Amoebae Keratitis
| Autor: | Antonella Mattana, Francesco Boscia, Tiziana Porcu, Antonio Daniele Pinna, Antonella Cano, G Erre |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Biguanides Acanthamoeba Treatment results DNA Ribosomal Polymerase Chain Reaction Keratitis Cornea 03 medical and health sciences 0302 clinical medicine medicine RNA Ribosomal 18S Animals Humans Eye Infections Parasitic Prospective Studies Amoeba DNA Primers Hartmannella biology business.industry Amebiasis 030108 mycology & parasitology Eye infection DNA Protozoan medicine.disease biology.organism_classification Dermatology Ophthalmology Ophthalmic solutions Corneal scrapings 030221 ophthalmology & optometry Female Ophthalmic Solutions business Disinfectants |
| Zdroj: | Cornea. 36(7) |
| ISSN: | 1536-4798 |
| Popis: | To describe the diagnostic and clinical features and treatment results in 43 consecutive patients with microbiologically proven free-living amoebae (FLA) keratitis.In this hospital-based, prospective case series, corneal scrapings from 43 patients with presumed amoebic keratitis were plated on nonnutrient agar. Amoebic isolates were identified morphologically and by the polymerase chain reaction. All patients with culture-proven FLA keratitis were treated with polyhexamethylene biguanide (PHMB) 0.02% eye drops.Forty-three corneal scrapings from 43 patients were found to be culture positive for FLA; 41 (95%) were from contact lens wearers and 2 (5%) were from noncontact lens wearers. Microscopic examination identified 4 Acanthamoeba spp, 24 Hartmannella spp, 12 vahlkampfiid amoebae, and 3 mixed infections with Hartmannella/vahlkampfiid amoebae. Morphological results were confirmed by the polymerase chain reaction. Patients with Acanthamoeba, Hartmannella, and vahlkampfiid keratitis had indistinguishable clinical features. In 38 eyes with keratitis at an early stage, treatment with PHMB 0.02% eye drops was fully successful. In 5 patients with advanced keratitis, topical PHMB 0.02% controlled the infection, but all of them developed a central corneal scar with visual deterioration.Acanthamoeba is not the only cause of amoebic keratitis, because this condition may also be caused by other FLA, such as Hartmannella and vahlkampfiid amoebae. This finding is epidemiologically interesting, suggesting a possible different geographical prevalence of the different FLA responsible for keratitis. Early diagnosis and proper antiamoebic treatment are crucial to yielding a cure. |
| Databáze: | OpenAIRE |
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