Investigation of the Role of Bacteria in the Development of Acanthamoeba Keratitis

Nakagawa, Hayate; Hattori, Takaaki; Koike, Naohito; Ehara, Tomoko; Fujita, Koji; Takahashi, Hiroki; Kumakura, Shigeto; Kuroda, Masahiko; Matsumoto, Tetsuya; Gotô, Hiroshi

doi:10.1097/ico.0000000000000541

Cited by 17 publications

(15 citation statements)

References 39 publications

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“…In this case, coinfection of bacteria may have been one reason of the severity of AK. This particular case in the severe group was interesting because the presence of bacteria in AK was reported to be a requirement for the development of AK 24…”

Section: Discussionmentioning

confidence: 95%

Risk factors and clinical signs of severe <em>Acanthamoeba</em> keratitis

Shimmura-Tomita

Takano

Kinoshita

et al. 2018

OPTH

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PurposeTo determine risk factors and clinical signs for severe Acanthamoeba keratitis (AK) by comparing severe cases with mild cases with good prognosis.Patients and methodsWe reviewed medical records of ten cases of AK (five males and five females) referred to our hospital and classified cases into two groups. One eye that required therapeutic keratoplasty and three eyes with a poor visual acuity (<0.2) on last visit were included in the severe group. Six eyes that had good prognosis with a visual acuity of 1.2 on last visit were classified as mild group. We compared patients’ age, the time required for diagnosis, visual acuity on first visit, the history of steroid eye drops use, and other clinical findings.ResultsThe average age of the severe group was older than the mild group (P=0.04). The duration between onset and diagnosis of AK and visual acuity on first visit was not statistically different. A history of steroid eye drop use was found in four eyes of the severe group (100%) and four eyes of the mild group (67%). Keratoprecipitates were found in all severe group eyes and one mild group eye during follow-up (P=0.01). One case in the severe group was diagnosed with diabetes mellitus at initial examination. We detected Staphylococcus epidermis by palpebral conjunctival culture in one case of the severe group.ConclusionAging may be a possible risk factor for severe AK. The presence of keratoprecipitates is a possible sign of severe AK. Attention is also required in patients with comorbidities such as diabetes mellitus and bacterial infection.

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Section: Discussionmentioning

confidence: 95%

Risk factors and clinical signs of severe <em>Acanthamoeba</em> keratitis

Shimmura-Tomita

Takano

Kinoshita

et al. 2018

OPTH

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“…The rationale for the use of antibiotics is the parasites thrive on bacteria, and phagosomes-containing bacteria have been demonstrated in the cytoplasm of the parasitic cells. [ 58 59 60 ] Similarly, there are reports on successful treatment of infection with the addition of voriconazole in patients not responding to conventional anti- Acanthamoeba treatment. [ 61 ] One can consider these additional therapies in patients not responding to conventional medical management.…”

Section: Treatmentmentioning

confidence: 99%

Non-contact lens related Acanthamoeba keratitis

Garg

Kalra

Joseph

2017

Indian J Ophthalmol

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The purpose of the study is to describe epidemiology, clinical features, diagnosis, and treatment of Acanthamoeba keratitis (AK) with special focus on the disease in nonusers of contact lenses (CLs). This study was a perspective based on authors’ experience and review of published literature. AK accounts for 2% of microbiology-proven cases of keratitis. Trauma and exposure to contaminated water are the main predisposing factors for the disease. Association with CLs is seen only in small fraction of cases. Contrary to classical description experience in India suggests that out of proportion pain, ring infiltrate, and radial keratoneuritis are seen in less than a third of cases. Majority of cases present with diffuse infiltrate, mimicking herpes simplex or fungal keratitis. The diagnosis can be confirmed by microscopic examination of corneal scraping material and culture on nonnutrient agar with an overlay of Escherichia coli. Confocal microscopy can help diagnosis in patients with deep infiltrate; however, experience with technique and interpretation of images influences its true value. Primary treatment of the infection is biguanides with or without diamidines. Most patients respond to medical treatment. Corticosteroids play an important role in the management and can be used when indicated after due consideration to established protocols. Surgery is rarely needed in patients where definitive management is initiated within 3 weeks of onset of symptoms. Lamellar keratoplasty has been shown to have good outcome in cases needing surgery. Since the clinical features of AK in nonusers of CL are different, it will be important for ophthalmologists to be aware of the scenario wherein to suspect this infection. Medical treatment is successful if the disease is diagnosed early and management is initiated soon.

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“…89 Nakagawa et al 89 showed that pretreatment of Acanthamoeba with levofloxacin markedly reduced disease activity, suggesting another potential, and readily available, treatment avenue.…”

Section: The Future?mentioning

confidence: 99%