Coinfection with Acanthamoeba and Pseudomonas in Contact Lens–Associated Keratitis

Abstract

Both P. aeruginosa and Acanthamoeba are potentially devastating causes of microbial keratitis. Our case highlights the importance of considering the possibility of a concurrent infection in cases with contact lens-related keratitis.

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

“…33,34 Despite the low sensitivity and long culture duration, debriding the epithelium at the time of scrape may be therapeutic in early AK by removing or reducing the total load of infective cysts and trophozoites. 1 In addition, rapid diagnosis was confirmed by microscopy in three cases in the current study (within 3 days), and in 16.7% of corneal scrapes superinfection with other organisms was identifieda common feature of AK noted in other reports 35,36 and a potential cause of poor response to treatment if undetected. 37 Corneal biopsy was conducted in three cases and demonstrated positive results in one case (33%) consistent with a previous study reporting the sensitivity of corneal biopsy for the diagnosis of AK.…”

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

“…33,34 Despite the low sensitivity and long culture duration, debriding the epithelium at the time of scrape may be therapeutic in early AK by removing or reducing the total load of infective cysts and trophozoites. 1 In addition, rapid diagnosis was confirmed by microscopy in three cases in the current study (within 3 days), and in 16.7% of corneal scrapes superinfection with other organisms was identifieda common feature of AK noted in other reports 35,36 and a potential cause of poor response to treatment if undetected. 37 Corneal biopsy was conducted in three cases and demonstrated positive results in one case (33%) consistent with a previous study reporting the sensitivity of corneal biopsy for the diagnosis of AK.…”

Concurrent contamination of Free-Living Amoebae and Legionella pneumophila in water resources of hospitals, A microscopic and molecular analysis

“…In fact, Pseudomonas increases the resistance of Acanthamoeba to contact lens disinfectant solutions and increases the survival of Acanthamoeba by forming bio lms on the surface of contact lenses. Coinfection of Pseudomonas and Acanthamoeba has also been reported in patients with keratitis (Sharma et al, 2013).…”

“…The prevalence of Legionella in drinking water ranged from 20.7% (49) to 32.7% (50) in Germany (Kruse et al, 2016), and different Legionella species were detected in 26% of hot water mains in residential buildings in Italy (Totaro et al, 2017). The co-occurrence of Legionella and FLA in water systems may suggest an increased health risk to individuals (Cervero-Aragó et al, 2015).…”

Case Series: Unusual Presentation of Acanthamoeba Coinfection in the Cornea

“…Perineuritis and epitheliitis are known presentations in early Acanthamoeba keratitis infection, but these two presentations are relatively unusual in Acanthamoeba keratitis coinfection. 1,[4][5][6][7]9 Perineuritis, a typical characteristic of Acanthamoeba keratitis, was also reported in contact lens-related microbial keratitis caused by P. aeruginosa. 12 Epitheliitis, a sign of Acanthamoeba keratitis, presenting in cases without any predisposing factor would imply existence of coinfection.…”

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

“…33,34 Despite the low sensitivity and long culture duration, debriding the epithelium at the time of scrape may be therapeutic in early AK by removing or reducing the total load of infective cysts and trophozoites. 1 In addition, rapid diagnosis was confirmed by microscopy in three cases in the current study (within 3 days), and in 16.7% of corneal scrapes superinfection with other organisms was identifieda common feature of AK noted in other reports 35,36 and a potential cause of poor response to treatment if undetected. 37 Corneal biopsy was conducted in three cases and demonstrated positive results in one case (33%) consistent with a previous study reporting the sensitivity of corneal biopsy for the diagnosis of AK.…”

Concurrent contamination of Free-Living Amoebae and Legionella pneumophila in water resources of hospitals, A microscopic and molecular analysis

“…In fact, Pseudomonas increases the resistance of Acanthamoeba to contact lens disinfectant solutions and increases the survival of Acanthamoeba by forming bio lms on the surface of contact lenses. Coinfection of Pseudomonas and Acanthamoeba has also been reported in patients with keratitis (Sharma et al, 2013).…”

“…The prevalence of Legionella in drinking water ranged from 20.7% (49) to 32.7% (50) in Germany (Kruse et al, 2016), and different Legionella species were detected in 26% of hot water mains in residential buildings in Italy (Totaro et al, 2017). The co-occurrence of Legionella and FLA in water systems may suggest an increased health risk to individuals (Cervero-Aragó et al, 2015).…”

Case Series: Unusual Presentation of Acanthamoeba Coinfection in the Cornea

“…Perineuritis and epitheliitis are known presentations in early Acanthamoeba keratitis infection, but these two presentations are relatively unusual in Acanthamoeba keratitis coinfection. 1,[4][5][6][7]9 Perineuritis, a typical characteristic of Acanthamoeba keratitis, was also reported in contact lens-related microbial keratitis caused by P. aeruginosa. 12 Epitheliitis, a sign of Acanthamoeba keratitis, presenting in cases without any predisposing factor would imply existence of coinfection.…”

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

“…33,34 Despite the low sensitivity and long culture duration, debriding the epithelium at the time of scrape may be therapeutic in early AK by removing or reducing the total load of infective cysts and trophozoites. 1 In addition, rapid diagnosis was confirmed by microscopy in three cases in the current study (within 3 days), and in 16.7% of corneal scrapes superinfection with other organisms was identifieda common feature of AK noted in other reports 35,36 and a potential cause of poor response to treatment if undetected. 37 Corneal biopsy was conducted in three cases and demonstrated positive results in one case (33%) consistent with a previous study reporting the sensitivity of corneal biopsy for the diagnosis of AK.…”

Concurrent contamination of Free-Living Amoebae and Legionella pneumophila in water resources of hospitals, A microscopic and molecular analysis

“…In fact, Pseudomonas increases the resistance of Acanthamoeba to contact lens disinfectant solutions and increases the survival of Acanthamoeba by forming bio lms on the surface of contact lenses. Coinfection of Pseudomonas and Acanthamoeba has also been reported in patients with keratitis (Sharma et al, 2013).…”

“…The prevalence of Legionella in drinking water ranged from 20.7% (49) to 32.7% (50) in Germany (Kruse et al, 2016), and different Legionella species were detected in 26% of hot water mains in residential buildings in Italy (Totaro et al, 2017). The co-occurrence of Legionella and FLA in water systems may suggest an increased health risk to individuals (Cervero-Aragó et al, 2015).…”

Case Series: Unusual Presentation of Acanthamoeba Coinfection in the Cornea

“…Perineuritis and epitheliitis are known presentations in early Acanthamoeba keratitis infection, but these two presentations are relatively unusual in Acanthamoeba keratitis coinfection. 1,[4][5][6][7]9 Perineuritis, a typical characteristic of Acanthamoeba keratitis, was also reported in contact lens-related microbial keratitis caused by P. aeruginosa. 12 Epitheliitis, a sign of Acanthamoeba keratitis, presenting in cases without any predisposing factor would imply existence of coinfection.…”