ACANTHAMOEBA INFECTION AS A CAUSE OF SEVERE KERATITIS IN A SOFT CONTACT LENS WEARER IN JAMAICA

ZOE WYNTER-ALLISON Division of Ophthalmology and Department of Microbiology, The University of the West Indies, Kingston, Jamaica; Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, La Laguna, Tenerife, Canary Islands, Spain

Search for other papers by ZOE WYNTER-ALLISON in
Current site
Google Scholar
PubMed Close
,
JACOB LORENZO MORALES Division of Ophthalmology and Department of Microbiology, The University of the West Indies, Kingston, Jamaica; Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, La Laguna, Tenerife, Canary Islands, Spain

Search for other papers by JACOB LORENZO MORALES in
Current site
Google Scholar
PubMed Close
,
DONOVAN CALDER Division of Ophthalmology and Department of Microbiology, The University of the West Indies, Kingston, Jamaica; Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, La Laguna, Tenerife, Canary Islands, Spain

Search for other papers by DONOVAN CALDER in
Current site
Google Scholar
PubMed Close
,
KRAIG RADLEIN Division of Ophthalmology and Department of Microbiology, The University of the West Indies, Kingston, Jamaica; Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, La Laguna, Tenerife, Canary Islands, Spain

Search for other papers by KRAIG RADLEIN in
Current site
Google Scholar
PubMed Close
,
ANTONIO ORTEGA-RIVAS Division of Ophthalmology and Department of Microbiology, The University of the West Indies, Kingston, Jamaica; Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, La Laguna, Tenerife, Canary Islands, Spain

Search for other papers by ANTONIO ORTEGA-RIVAS in
Current site
Google Scholar
PubMed Close
, and
JOHN F. LINDO Division of Ophthalmology and Department of Microbiology, The University of the West Indies, Kingston, Jamaica; Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, La Laguna, Tenerife, Canary Islands, Spain

Search for other papers by JOHN F. LINDO in
Current site
Google Scholar
PubMed Close
DOI:
https://doi.org/10.4269/ajtmh.2005.73.92
Volume/Issue:
Volume 73: Issue 1
Page(s):
92–94
Restricted access
Get Permissions

We report the case of a 29-year-old Jamaican patient who presented with severe pain, redness, and swelling of both eyes. She was a regular soft contact lens wearer who did not maintain standard lens care. She was treated for a possible microbial/viral keratitis using topical ciprofloxacin drops, topical acyclovir ointment, and topical atropine drops. The response was inadequate, and scrapings from her cornea, contact lens cases, and both lenses revealed Acanthamoeba on microscopy, which was shown to be Acanthamoeba polyphaga using polymerase chain reaction. She was treated using chlorhexidine 0.02% hourly, ciprofloxacin every 4 hours, and atropine 1% every 12 hours, along with oral ketoconazole 200 mg twice daily with a dramatic response. However, she subsequently suffered slow corneal epithelial regrowth with severe scarring, vascularization, and cortical lens opacification and was referred for penetrating keratoplasty and cataract surgery. This is the first case of severe keratitis caused by Acanthamoeba to be reported from Jamaica and demonstrates that this emerging pathogen can be a cause of severe keratitis in the tropics.

Copyright:
Copyright 2005 The American Society of Tropical Medicine 2005
Received:
02 Sep 2004
|
Accepted:
26 Jan 2005
|
Published Online:
Jul 2005
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
  • 1

    Armstrong M, 2000. The pathogenesis of human Acanthamoeba infection. Infect Dis Rev 2 :65–73.

  • 2

    Marciano-Cabral F, Cabral G, 2003. Acanthamoeba spp. as agents of disease in humans. Clin Microbiol Rev 16 :273–307.

  • 3

    Radford CF, Lehman O, Dart JKG, 1998. Acanthamoeba keratitis: multicentre survey in England 1992-6. National Acanthamoeba Keratitis Study Group. Br J Ophthalmol 82 :1387–1392.

    • Search Google Scholar
    • Export Citation
  • 4

    Vodkin MH, Howe DK, Visvesvara GS, McLaughlin GL, 1992. Identification of Acanthamoeba at the generic and specific levels using the polymerase chain reaction. J Protozool 39 :378–385.

    • Search Google Scholar
    • Export Citation
  • 5

    Ortega-Rivas A, Lorenzo-Morales J, Alonso V, Abreu N, Foronda P, Del Castillo A, Valladares B, 2003. Random amplified polymorphic DNA as a tool for the identification of Acanthamoeba divionensis. Curr Microbiol 47 :84–86.

    • Search Google Scholar
    • Export Citation
  • 6

    Ortega-Rivas A, Lorenzo-Morales J, Villa M, Martinez E, Valladares B, Del Castillo A, 2004. Design and evaluation of a specific primer pair for the identification of Acanthamoeba polyphaga. Curr Microbiol 48 :360–363.

    • Search Google Scholar
    • Export Citation
  • 7

    Gonzalez MM, Gould E, Dickinson G, Martinez AJ, Visvesvara G, Cleary TJ, Hensley GT, 1986. Acquired immunodeficiency syndrome associated with Acanthamoeba infection and other opportunistic organisms. Arch Pathol Lab Med 110 :749–751.

    • Search Google Scholar
    • Export Citation
  • 8

    Radford CF, Minassian DC, Dart JK, 2002. Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. Br J Ophthalmol 86 :536–542.

    • Search Google Scholar
    • Export Citation
  • 9

    Morlet N, Duguid G, Radford C, Matheson M, Dart J, 1997. Incidence of Acanthamoeba keratitis associated with contact lens wear. Lancet 350 :414.

    • Search Google Scholar
    • Export Citation
  • 10

    Stehr-Green JK, Bailey TM, Brandt FH, Carr JH, Bond WW, Visvesvara GS, 1987. Acanthamoeba keratitis in soft contact lens wearers. A case-control study. JAMA 258 :57–60.

    • Search Google Scholar
    • Export Citation
  • 11

    Khan NA, 2003. Pathogenesis of Acanthamoeba infections. Microb Pathog 34 :277–285.

  • 12

    Seal D, Beattie TK, Tomlinson A, Fan D, Wong E, 2003. Acanthamoeba keratitis. Br J Ophthalmol 87 :516–517.

  • 13

    Kilvington S, Larkin DF, White DG, Beeching JR, 1990. Laboratory investigation of Acanthamoeba keratitis. J Clin Microbiol 28 :2722–2725.

    • Search Google Scholar
    • Export Citation
  • 14

    Illingworth CD, Cook SD, Karabatsas CH, Easty DL, 1995. Acanthamoeba keratitis: risk factors and outcome. Br J Ophthalmol 79 :1078–1082.

    • Search Google Scholar
    • Export Citation
  • 15

    Hirst LW, Green WR, Merz W, Kaufmann C, Visvesvara GS, Jensen A, Howard M, 1984. Management of Acanthamoeba keratitis. A case report and review of the literature. Ophthalmology 91 :1105–1111.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 22 22 3
Full Text Views 257 75 0
PDF Downloads 54 19 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save