• 1.

    Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN, 2002. The Epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in south India. Cornea 21: 555559.

    • Search Google Scholar
    • Export Citation
  • 2.

    Sharma S, Garg P, Rao GN, 2000. Patients characteristics, diagnosis and treatment of non-contact lens related Acanthamoeba keratitis. Br J Ophthalmol 84: 11031108.

    • Search Google Scholar
    • Export Citation
  • 3.

    Nunes TE, Brazil NT, Fuentefria AM, Rott MB, 2016. Acanthamoeba and Fusarium interactions: a possible problem in keratitis. Acta Trop 157: 102107.

    • Search Google Scholar
    • Export Citation
  • 4.

    Froumis NA, Mondino BJ, Glasgow BJ, 2001. Acanthamoeba keratitis associated with fungal keratitis. Am J Ophthalmol 131: 508509.

  • 5.

    Tien SH, Sheu MM, 1999. Treatment of Acanthamoeba keratitis combined with fungal infection with polyhexamethylene biguanide. Kaohsiung J Med Sci 15: 665673.

    • Search Google Scholar
    • Export Citation
  • 6.

    Slade DS, Johnson JT, Tabin G, 2008. Acanthamoeba and fungal keratitis in a woman with a history of intacs corneal implants. Eye Contact Lens 34: 185187.

    • Search Google Scholar
    • Export Citation
  • 7.

    Lee WB, Grossniklaus HE, Edelhauser HF, 2010. Concurrent Acanthamoeba and Fusarium keratitis with silicone hydrogel contact lens use. Cornea 29: 210213.

    • Search Google Scholar
    • Export Citation
  • 8.

    Lin HC, Hsiao CH, Ma DH, Yeh LK, Tan HY, Lin MY, Huang SCM, 2009. Medical treatment for combined Fusarium and Acanthamoeba keratitis. Acta Ophthalmol 87: 199203.

    • Search Google Scholar
    • Export Citation
  • 9.

    Lin HC, Chu PH, Kuo YH, Shen SC, 2005. Clinical experience in managing Fusarium solani keratitis. Int J Clin Pract 59: 549554.

  • 10.

    Gopinathan U, Sharma S, Garg P, Rao GN, 2009. Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade. Indian J Ophthalmol 57: 273279.

    • Search Google Scholar
    • Export Citation
  • 11.

    Luna LG, 1968. Manual of Histologic Staining Methods of the Armed Forces Institute of Pathology. New York, NY: McGraw-Hill.

  • 12.

    Bharathi MJ, Ramakrishnan R, Meenakshi R, Shivakumar C, Raj DL, 2009. Analysis of the risk factors predisposing to fungal, bacterial & Acanthamoeba keratitis in south India. Indian J Med Res 130: 749757.

    • Search Google Scholar
    • Export Citation
  • 13.

    Gupta N, Samantaray JC, Duggal S, Srivastava V, Dhull CS, Chaudhary U, 2010. Acanthamoeba keratitis with Curvularia co-infection. Indian J Med Microbiol 28: 6771.

    • Search Google Scholar
    • Export Citation
  • 14.

    Rumelt S, Cohen I, Lefter E, Rehany U, 2001. Corneal coinfection with Scedosporium apiospermum and Acanthamoeba after sewage contaminated ocular injury. Cornea 20: 112116.

    • Search Google Scholar
    • Export Citation
  • 15.

    Gussler JR, Miller D, Jaffe M, Alfonso EC, 1995. Infection after radial keratotomy. Am J Ophthalmol 119: 798799.

  • 16.

    Babu K, Murthy KR, 2007. Combined fungal and Acanthamoeba keratitis: diagnosis by in vivo confocal microscopy. Eye (Lond) 21: 271272.

  • 17.

    Hu J, Wang Y, Xie L, 2009. Potential role of macrophages in experimental keratomycosis. Invest Ophthalmol Vis Sci 50: 20872094.

 

 

 

 

Case Report: Corneal Coinfection with Fungus and Amoeba: Report of Two Patients and Literature Review

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  • 1 Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, India;
  • 2 Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Hyderabad, India

We report two cases of corneal coinfection with Acanthamoeba and Fusarium sp. along with the review of published literature. A 35-year-old woman and 65-year-old man presented to the institute with corneal ulcer refractory for treatment with topical antibiotics. Microbiological examination revealed the presence of Acanthamoeba cysts along with septate, hyaline fungal filaments. After emergency therapeutic penetrating keratoplasty (TPK) in both, the corneal tissue was sent for histopathologic examination, which confirmed the presence of Acanthamoeba and fungal coinfection. One patient had a recurrence of fungal infection after TPK. In subjects with a rapid progression of mycotic ulcer, coinfection with other microorganisms including Acanthamoeba should be suspected. The two cases presented here emphasize the importance of microbiology in making prompt diagnosis and appropriate management of these cases at an early stage.

Author Notes

Address correspondence to Joveeta Joseph, Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Banjara Hills, Rd. No 2, Hyderabad, Telangana 500034, India. E-mail: joveeta@lvpei.org

Ethical approval: Informed consent was obtained from all individual participants included in the study.

Authors’ addresses: Joveeta Joseph and Savitri Sharma, Jhaveri Microbiology Centre, L. V. Prasad Eye Institute, Hyderabad, India, E-mails: joveeta@lvpei.org and savitri@lvpei.org. Sunita Chaurasia, Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Hyderabad, India, E-mail: sunita@lvpei.org.

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