Demirci Göktuğ, Ay Gülten Manav, Karabas Levent V, Altintas Ozgül, Tamer Gülden S, Cağlar Yusuf
Ophthalmology Department, Medical Faculty of Kocaeli University, Kocaeli, Turkey.
Cornea. 2006 Apr;25(3):356-8. doi: 10.1097/01.ico.0000178723.26940.74.
This study was designed to report a case of acanthamoeba keratitis in a 5-year-old child without a history of trauma or contact lens usage.
The history, clinical presentation, diagnostic, and therapeutic approaches were reviewed.
A 5-year-old child without any history of trauma or contact lens use was referred to our university clinic with an initial diagnosis of disciform herpetic keratitis. After 2 weeks of antibacterial and antiviral therapy, a corneal biopsy was performed for diagnostic purposes. The biopsy revealed acanthamoeba. Subsequently intensive therapy with chlorhexidine diacetate 0.02%, ketoconazole tb, hexamidine di-isethionate 0.1% was initiated. At the end of the first month, topical prednisolone acetate 1% was added to reduce inflammation, Chlorhexidine diacetate 0.02% and oral ketoconazole were discontinued, and hexamidine di-isethionate 0.1% was lowered to 4 x 1 and was administered for an additional 4 months. At the end of 5 months, all medications were withdrawn and amblyopia treatment was started.
When dealing with keratitis in children, acanthamoeba should be considered even without history of contact lens usage or trauma.
本研究旨在报告一例5岁儿童患棘阿米巴角膜炎的病例，该患儿无外伤史或隐形眼镜使用史。
回顾病史、临床表现、诊断及治疗方法。
一名无任何外伤史或隐形眼镜使用史的5岁儿童被转诊至我校诊所，初步诊断为盘状疱疹性角膜炎。经过2周的抗菌和抗病毒治疗后，为明确诊断进行了角膜活检。活检显示为棘阿米巴。随后开始使用0.02%双醋酸氯己定、酮康唑tb、0.1%乙磺半胱氨酸进行强化治疗。在第一个月末，添加1%醋酸泼尼松龙以减轻炎症，停用0.02%双醋酸氯己定和口服酮康唑，将0.1%乙磺半胱氨酸降至4×1并再使用4个月。在5个月末，停用所有药物并开始弱视治疗。
在处理儿童角膜炎时，即使没有隐形眼镜使用史或外伤史，也应考虑棘阿米巴感染。
