Orosz Erika, Kriskó Dorottya, Shi Lei, Sándor Gábor L, Kiss Huba J, Seitz Berthold, Nagy Zoltán Zsolt, Szentmáry Nóra
Department of Parasitology,National Public Health Center, Budapest,Hungary.
Department of Ophthalmology,Semmelweis University, Budapest,Hungary.
Acta Microbiol Immunol Hung. 2019 Sep 1;66(3):289-300. doi: 10.1556/030.66.2019.008. Epub 2019 Mar 5.
Genus is an opportunistic protozoan that is widely distributed in the environment. Within this genus, numerous species are recognized as human pathogens, potentially causing keratitis (AK). AK is a corneal disease, associated predominantly with contact lens (CL) wear; its epidemiology is related to the specific genotypes. This study reports seven CL wearer, PCR-positive patients with AK, diagnosed between January 2015 and 2018. Patients had the diagnosis of AK 1.36 months after first symptoms. Genotyping allowed the identification of six isolates of the T4 and one of the T8 genotypes. At first presentation, pseudendritiformic epithelopathy/dirty epithelium (four eyes, 57.1%), multifocal stromal infiltrates (five eyes, 71.4%), ring infiltrate (three eyes, 42.8%), and perineuritis (one eye, 14.3%) were observed. AK was healed without later recurrence in two eyes (28.5%) using triple-topical therapy, in three eyes (42.8%) following additional penetrating keratoplasty. In one patient (14.3%), AK recurred following successful application of triple-therapy and was treated successfully with repeated triple-topical therapy and in one patient (14.3%), no follow-up data were available after diagnosis. We could not observe correlation of genotype and clinical course or the necessity of corneal transplantation in our case series.
属是一种机会性原生动物,广泛分布于环境中。在该属中,许多物种被认为是人类病原体,可能导致棘阿米巴角膜炎(AK)。AK是一种角膜疾病,主要与佩戴隐形眼镜(CL)有关;其流行病学与特定基因型相关。本研究报告了2015年1月至2018年期间诊断的7例佩戴CL且PCR检测呈阳性的AK患者。患者在出现首发症状后1.36个月被诊断为AK。基因分型鉴定出6株T4基因型菌株和1株T8基因型菌株。初次就诊时,观察到假树枝状上皮病变/脏上皮(4只眼,57.1%)、多灶性基质浸润(5只眼,71.4%)、环形浸润(3只眼,42.8%)和神经炎(1只眼,14.3%)。2只眼(28.5%)采用三联局部治疗后AK治愈且无后期复发;另外3只眼(42.8%)在接受穿透性角膜移植术后治愈。1例患者(14.3%)在三联疗法成功应用后AK复发,经重复三联局部治疗成功治愈;1例患者(14.3%)诊断后无随访数据。在我们的病例系列中,未观察到基因型与临床病程之间的相关性或角膜移植的必要性。