Alfawaz Abdullah
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Middle East Afr J Ophthalmol. 2011 Jul;18(3):252-5. doi: 10.4103/0974-9233.84062.
The visual outcomes of Acanthamoeba keratitis, a rare cause of corneal infection, can be devastating. This paper reports two contact lens wearers with severe pain and photophobia who presented to the emergency room. Biomicroscopy revealed radial keratoneuritis in both individuals. Tissue culture on a nonnutrient agar plate with Escherichia coli overlay resulted in a heavy growth of Acanthamoeba. The inpatient treatment included 0.02% polyhexamethylene biguanide, chlorhexidine, neomycin/polymyxin B/bacitracin (Neosporin), and oral fluconazole, which successfully controlled the corneal infection and improvement in the best corrected visual acuity in both patients. Infection did not recur during the 12-month follow-up period. Acanthamoeba keratitis can present as radial keratoneuritis, mimicking other common corneal infections resulting in diagnostic and treatment delays. Early diagnosis and prudent treatment of Acanthamoeba keratitis are the keys to restoring vision and avoiding the subsequent need for penetrating keratoplasty.
棘阿米巴角膜炎是一种罕见的角膜感染病因，其视觉预后可能是灾难性的。本文报告了两名因严重疼痛和畏光而前往急诊室就诊的隐形眼镜佩戴者。生物显微镜检查显示两人均有放射状角膜神经炎。在含大肠杆菌覆盖物的非营养琼脂平板上进行组织培养，结果显示棘阿米巴大量生长。住院治疗包括0.02%的聚六亚甲基双胍、洗必泰、新霉素/多粘菌素B/杆菌肽（新孢霉素）和口服氟康唑，成功控制了角膜感染，两名患者的最佳矫正视力均有改善。在12个月的随访期内感染未复发。棘阿米巴角膜炎可表现为放射状角膜神经炎，类似于其他常见的角膜感染，从而导致诊断和治疗延误。早期诊断和谨慎治疗棘阿米巴角膜炎是恢复视力并避免随后进行穿透性角膜移植术的关键。
