To describe the clinical course of a patient with Acanthamoeba keratitis, who despite prompt treatment progressed to histopathology-confirmed Acanthamoeba retinitis and endophthalmitis.
Case report.
A healthy 30-year-old male wearing soft contact lens was diagnosed with Acanthamoeba keratitis and treated medically and surgically over the course of 1 year with presumed resolution of the infection. Yet, his infection recurred with documented spread to sclerokeratitis, and overwhelming endophthalmitis. Concerns about extra-ocular spread prompted a therapeutic enucleation with histopathologic evidence of Acanthamoeba organisms throughout the globe.
This is a case of a severe recurrent Acanthamoeba infection presenting initially as keratitis, followed by sclerokeratitis and histolopathology-confirmed endophthalmitis. This case demonstrates that despite persistent medical and surgical intervention, eradication of organisms may not be possible.
Extra-corneal manifestations of Acanthamoeba keratitis are uncommon but may be sight-threatening. These manifestations include sclerokeratitis and rarely posterior segment involvement. We describe the clinical and histopathologic findings of a rare case of Acanthamoeba keratitis which progressed to infectious sclerokeratitis and endophthalmitis.
*Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada;
†VitreoRetinal Surgery, PA, Minneapolis, Minnesota;
‡Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa city, Iowa; and
§Department of Ophthalmology, Omics Laboratory, Iowa City, Iowa.
Reprint requests: Vinit B. Mahajan, MD, PhD, Department of Ophthalmology, Omics Laboratory, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242; e-mail: vinit-mahajan@uiowa.edu
Supported by Research to Prevent Blindness.
None of the authors have any conflicting interests to disclose.
