Abstract
A 31-year-old female daily user of contact lenses sought medical attention, reporting blurred vision and irritation of the left eye. Slit-lamp examination revealed hyperemia and an irregular corneal epithelium surface, and empirical treatment was started. A corneal scrape was obtained and examined for the presence of fungi, bacteria, and Acanthamoeba spp. The results of the microbial culture revealed growth of Acanthamoeba spp. and Candida albicans. The Acanthamoeba isolate was characterized by cyst morphology as belonging to group II according to Pussard and Pons. Sequencing of the diagnostic fragment 3 (DF3) region located on the 18S ribosomal DNA identified the isolate as genotype T4. The patient was treated with chlorhexidine 0.02% and polyhexamethylene biguanide (PHMB) 0.02% drops for 5 months until the infection resolved. Lately, rare cases of polymicrobial keratitis associated with Acanthamoeba and Candida albicans have been reported. Cases of co-infection are more difficult to treat, since the specific treatment depends on precise identification of the agents involved.
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The authors thank the Clinical analysis Department of the Federal University of Santa Catarina, Brazil, and Dr. Janet W. Reid who revised the English text.
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This study received financial support from CAPES and CNPq.
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We obtained approval for this study from the Committee for Human Research at the University of Santa Catarina, Florianópolis (CAAE No. 32938014.5.0000.0121).
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Buchele, M.L.C., Wopereis, D.B., Casara, F. et al. Contact lens-related polymicrobial keratitis: Acanthamoeba spp. genotype T4 and Candida albicans. Parasitol Res 117, 3431–3436 (2018). https://doi.org/10.1007/s00436-018-6037-x
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DOI: https://doi.org/10.1007/s00436-018-6037-x