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Co-isolation of Vahlkampfia and Acanthamoeba in Acanthamoeba-Like Keratitis in a Spanish Population

Arnalich-Montiel, Francisco PhD; Lorenzo-Morales, Jacob PhD; Irigoyen, Cristina MD; Morcillo-Laiz, Rafael PhD; López-Vélez, Rogelio PhD; Muñoz-Negrete, Francisco PhD; Piñero, Jose E. PhD; Valladares, Basilio PhD

doi: 10.1097/ICO.0b013e31825697e6
Clinical Science

Purpose: To report the co-isolation incidence of Acanthamoeba and Vahlkampfia in amoebic keratitis from a tertiary care institution in Madrid, Spain.

Methods: In this retrospective case series, 7 eyes of 7 consecutive patients with culture-proven or polymerase chain reaction–positive Acanthamoeba keratitis were seen at a tertiary care institution from January 2010 to April 2011, and their charts were reviewed.

Results: Two of 7 patients showed mixed Acanthamoeba and Vahlkampfia keratitis. Good clinical response to the treatment was strongly correlated with early diagnosis, whereas delayed diagnosis resulted in poor response to the treatment in single or mixed infection.

Conclusions: Co-isolation of Vahlkampfia and Acanthamoeba in Acanthamoeba-like keratitis has recently been detected in our population. This finding should raise awareness of the existence of other amoeba different from Acanthamoeba causing keratitis. There are not enough cases yet to determine the impact of mixed amoebic keratitis in the prognosis of this disease.

*Cornea Unit, Ophthalmology Department, Ramón y Cajal Hospital, Madrid, Spain

University Institute of Tropical Diseases of the Canary Islands, University of La Laguna, Tenerife, Spain

Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain

Reprints: Francisco Arnalich-Montiel, Servicio de Oftalmología, Hospital Ramón y Cajal de Madrid, Carretera de Colmenar Viejo km. 9.100, 28034 Madrid, Spain (e-mail:

J.L.M. was supported by the Ramón y Cajal Subprogramme of the Spanish Ministry of Science and Innovation RYC-2011-08863. This work was partially funded by project RICET (project no. RD06/0021/0005 of the programme of Redes Temáticas de Investigación Cooperativa, FIS), Spanish Ministry of Health, Madrid, Spain, and the project “Protozoosis emergentes por amebas de vida libre: aislamiento y caracterización molecular, identificación de cepas transportadas de otros agentes patógenos y búsqueda de quimioterapias” PO10/01298, Spanish Ministry of Science and Innovation, Madrid, Spain. This work was also supported by grants to F.A.-M. from DGTATX, Ministerio de Sanidad y Consumo (Proyecto TRA-036), and Fundación Mutua Madrileña, Spain.

The authors have no funding or conflicts of interest to disclose.

Received November 9, 2011

Accepted March 19, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.