Contact lens-related polymicrobial keratitis: Acanthamoeba spp. genotype T4 and Candida albicans
Contact lens-related polymicrobial keratitis: Acanthamoeba spp. genotype T4 and Candida albicans
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DOI：
10.1007/s00436-018-6037-x
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发表时间：
2018-11-01
影响因子：
2
通讯作者：
Caumo, Karin Silva
中科院分区：
文献类型：
--
作者：
Carneiro Buchele, Maria Luiza;Wopereis, Debora Borgert;Caumo, Karin Silva
一名31岁的女性日常使用隐形眼镜者寻求医疗照顾，报告视力模糊和左眼刺激。裂隙灯检查显示充血和不规则的角膜上皮表面，并开始经验性治疗。获取角膜刮片并检查是否存在真菌、细菌和阿米巴属。微生物培养的结果显示阿米巴属的生长。和白色念珠菌。根据Pussard和脑桥，阿米巴分离株的包囊形态特征为属于II组。对位于18S核糖体DNA上的诊断片段3（DF3）区域进行测序，确定该分离株为基因型T4。患者接受0.02%氯己定和0.02%聚双胍（PHMB）滴剂治疗5个月，直至感染消退。最近，与阿米巴和白色念珠菌相关的多菌性角膜炎的罕见病例已有报道。合并感染的病例更难治疗，因为具体的治疗取决于对所涉病原体的精确鉴定。
A 31-year-old female daily user of contact lenses sought medical attention, reporting blurred vision and irritation of the left eye. Slit-lamp examination revealed hyperemia and an irregular corneal epithelium surface, and empirical treatment was started. A corneal scrape was obtained and examined for the presence of fungi, bacteria, and Acanthamoeba spp. The results of the microbial culture revealed growth of Acanthamoeba spp. and Candida albicans. The Acanthamoeba isolate was characterized by cyst morphology as belonging to group II according to Pussard and Pons. Sequencing of the diagnostic fragment 3 (DF3) region located on the 18S ribosomal DNA identified the isolate as genotype T4. The patient was treated with chlorhexidine 0.02% and polyhexamethylene biguanide (PHMB) 0.02% drops for 5 months until the infection resolved. Lately, rare cases of polymicrobial keratitis associated with Acanthamoeba and Candida albicans have been reported. Cases of co-infection are more difficult to treat, since the specific treatment depends on precise identification of the agents involved.