Acanthamoeba keratitis. Report of 3cases diagnosed in central Tunisia.
##plugins.themes.academic_pro.article.main##
Abstract
Background: Amoeba of the genus Acanthamoeba are ubiquitous free-living protozoa encountered in water and soil. They frequently cause sight-threatening keratitis.
Aim: report of the three first cases diagnosed at the laboratory of Parasitology of Sousse Hospital, (Tunisia).
Case report: Our study concern three lens-wearing female patients, aged 17, 20 and 29 years respectively. The patients originate from central Tunisia and presented with unilateral (2 cases) or bilateral (one case) keratitis. Diagnosis was made by demonstrating Acanthamoeba trophozoites and/or cysts on direct examination and/or culture (in agar - Escherichia coli medium) of contact lenses and/or lenses’ solution. Direct examination of corneal swabs was negative in three cases but culture was positive in one. The three patients were treated with hexamidine and neomycine eye-drops for three months.Treatment led to scarring of lesions with however sequellar opacities that was minor to moderate in two cases and consisted of a central leucoma with a poor visual outcome in the last case.
Conclusion: The need for systematic research of amoeba in lenses wearing patients with keratitis is emphasized.
Keywords:
Acanthamoeba, Keratitis, Lenses, Sousse, Tunisia##plugins.themes.academic_pro.article.details##
References
- Debbach C, Chaumeil C, Battelier L, Scat Y. Etude rétrospective sur deux ans de 344 patients ayant consulté pour une lésion cornéenne et chez lesquels une recherche d'amibes libres a été effectué. J Fr Ophtalmol 1999; 22: 848-852.
- Marciano-Cabral F, Puffenbarger R, Cabral G. The increasing importance of Acanthamoeba infections. J Eukaryot Microbiol 2000; 47: 29-36.
- Alisadeh H, Neelman S, Hurt M, Niederkorn JY. Role of contact lens wear, bacterial flora, and mannose-induced pathogenic protease in the pathogenesis of amoebic keratitis. Infect Immun 2005; 73:1061-1068.
- Cabral FM, Cabral G. Acanthamoeba spp. as agents of disease in humans. Clin Microbiol Rev, 2003; 16 : 273-307.
- Cardine S, Bourcier T, Chaumeil C, et al. Pris en charge clinique et pronostic des kératites amibiennes : Etude rétrospective à propos de 25 cas. J Fr Ophtalmol 2002 ; 25 :1007-1013.
- Chynn EW, Lopez MA, Pavan-Langston D, Talamo JH. Acanthamoeba keratitis. Contact lens and noncontact lens characteristics. Ophtalmology 1995 ; 102 :1369-1373.
- Jons DB, Visvesvara GS, Robinson NM. Acanthamoeba polyphaga keratitis and Acanthamoeba uveitis associated with fatal meningoencephalitis. Trans Ophtalmol Soc UK 1975; 95 : 221-232.
- Illingworth CD, Cook SD, Karabatsas CH, Easty DL. Acanthamoeba keratitis: risk factor and outcome. Br J Ophtalmol 1995; 79: 1078-1082.
- Stehr-Green JK, Bailey TM, Vivesvara GS. The epidemiology of Acanthamoeba keratitis in the United States. Am J Ophtalmol 1989; 107: 331-336.
- Lakomy D, Soulie M, Bador J, et al. Une kératite à amibes libres chez un non porteur de lentilles de contact. Ann Biol Clin 2005 ; 63: 531-534.
- Ben Salah S, Makni F, Cheikrouhou f, et al. Les kératites amibiennes: à propos des deux premiers cas tunisiens.Bull Soc Pathol Exot 2007 ;100 : 1, 41- 42.
- Leluan P, Liotet S, Batellier L, Chaumeil C. Contamination amibienne et bactérienne des étuis de lentilles de contact en France (étude de 32 cas de kératites et de 63 porteurs sains). Contactologia 1991; 13: 137-141.
- Clarke DW, Niederkorn JY. the pathophysiology of Acanthamoeba keratitis. Trends Parasitol 2006; 22: 175-180.
- Larkin DFP, Easty DL. Experimental Acanthamoeba keratitis: I Preliminary findings. Br J Ophtalmol 1990; 74: 551-555.
- Garnier A. Pathogenesis of Acanthamoeba keratitis: hypothesis based on a histological analysis of 30 cases. Br J Ophtalmol 1993; 77: 366-370.
- Illingworth CD, Cook SD. Acanthamoeba keratitis. Surv Ophtalmol 1998; 42 :493-508.
- Naacke H, Bourcier T, Chaumeil C, et al. Nouveaux outils diagnostiques dans la kératite amibienne : PCR et microscopie confocale. J Fr Ophtalmol 2002 ; 25(5) : 111-112.
- Pasricha G, Sharma S, Garg P, Aggawal RK - Use of 18S rRNA gene-based PCR assay for diagnosis of Acanthamoeba keratitis in non-contact lens wearers in India. J Clin Microbiol 2003; 41: 3206- 3211.