Ferrari Giulio, Matuska Stanislav, Rama Paolo
Bietti Eye Foundation, Rome, Italy.
Case Rep Ophthalmol. 2011 Sep;2(3):338-42. doi: 10.1159/000334270. Epub 2011 Nov 5.
To report the clinical and diagnostic findings of a patient with Acanthamoeba keratitis resistant to both polyhexamethylene biguanide (PHMB)-hexamidine and chlorhexidine-hexamidine treatment.
Slit-lamp biomicroscopy, corneal cell scraping and histopathology were performed on a 39-year-old woman presenting with corneal ulcer in her left eye.
The patient was successfully treated with PHMB-chlorhexidine association therapy. Subsequent perforating keratoplasty remained clear at the last follow-up visit after 7 months and increased visual acuity to 20/20 with correction.
This case emphasizes the proteiform aspects of Acanthamoeba drug resistance, and suggests that PHMB-chlorhexidine association might represent an additional option for cases resistant to standard therapy.
报告一名对聚六亚甲基双胍（PHMB）-己脒和氯己定-己脒治疗均耐药的棘阿米巴角膜炎患者的临床及诊断结果。
对一名左眼患有角膜溃疡的39岁女性进行裂隙灯生物显微镜检查、角膜细胞刮片及组织病理学检查。
该患者通过PHMB-氯己定联合治疗获得成功。在7个月后的最后一次随访中，后续的穿透性角膜移植术保持清晰，矫正视力提高到20/20。
本病例强调了棘阿米巴耐药的多种表现形式，并表明PHMB-氯己定联合治疗可能是对标准治疗耐药病例的另一种选择。
