Lone Rubina, Syed Khurshid, Abdul Rashid, Sheikh Sajjad Ahmed, Shah Faisal
SKIMS Medical College, Microbiology, Bemina, Srinagar, 190017, India.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.08.2008.0642. Epub 2009 Apr 14.
Acanthamoeba species can cause a chronic, progressive, ulcerative keratitis of the eye, which is not responsive to the usual antimicrobial treatment and is frequently mistaken for stromal herpes keratitis. Acanthamoeba keratitis continues to be a burgeoning and unsolved problem. Although soft contact lens wear is reported as the major risk factor in other parts of the world, reports from India suggest that acanthamoeba keratitis is more common among non-contact lens wearers. An unusual case of coinfection with Acanthamoeba and methicillin resistant staphylococcus aureus (MRSA) as causes of corneal keratitis in a contact lens wearer from Kashmir, India, is reported. Recent findings have shown that MRSA uses amoebae to spread, sidestepping hospital and other protection measures. Cysts of the isolated Acanthamoeba tolerated an incubation temperature of 40°C, indicating a pathogenic species. This case highlights the importance of culture methods in the diagnosis of corneal infection and the choice of treatment regimen.
棘阿米巴属可引起眼部慢性、进行性、溃疡性角膜炎，这种角膜炎对常规抗菌治疗无反应，且常被误诊为基质性疱疹性角膜炎。棘阿米巴角膜炎仍然是一个不断涌现且尚未解决的问题。尽管在世界其他地区，佩戴软性隐形眼镜被报道为主要危险因素，但来自印度的报告表明，棘阿米巴角膜炎在非隐形眼镜佩戴者中更为常见。本文报道了一例来自印度克什米尔地区的隐形眼镜佩戴者，同时感染棘阿米巴和耐甲氧西林金黄色葡萄球菌（MRSA）导致角膜角膜炎的罕见病例。最近的研究发现表明，MRSA利用变形虫进行传播，从而避开医院和其他防护措施。分离出的棘阿米巴囊肿能耐受40°C的培养温度，表明这是一种致病物种。该病例凸显了培养方法在角膜感染诊断及治疗方案选择中的重要性。
