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18S rDNA sequencing aided diagnosis of Acanthamoeba jacobsi keratitis -A case report.


ABSTRACT: Identification of Acanthamoeba cysts and trophozoites in cases of keratitis is traditionally done with microbiological techniques such as smear examination with 10% potassium hydroxide (KOH) and culture. Double walled cyst with hexagonal inner wall is characteristic of Acanthamoeba. We report a unique case of a 9 year old boy who presented with dense anterior corneal stromal infltration, which on smear examination showed atypical double walled spherical cysts, leading to a diagnostic dilemma. An 18S rRNA gene-based PCR done on the growth on culture, subsequently identifed a rarely reported species of Acanthamoeba. The patient was advised combination therapy with polyhexamethylene biguanide (PHMB 0.02%) and chlorhexidine (0.02%) eye drops. Three weeks post treatment, the keratitis resolved with scarring and vascularisation and visual acuity improved to 20/60. At 8 weeks follow up Best corrected visual acuity further improved to 20/30 with contact lens.

SUBMITTER: Singh A 

PROVIDER: S-EPMC6836588 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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18S rDNA sequencing aided diagnosis of <i>Acanthamoeba jacobsi</i> keratitis -A case report.

Singh Aastha A   Acharya Manisha M   Jose Nicy N   Gandhi Arpan A   Sharma Savitri S  

Indian journal of ophthalmology 20191101 11


Identification of Acanthamoeba cysts and trophozoites in cases of keratitis is traditionally done with microbiological techniques such as smear examination with 10% potassium hydroxide (KOH) and culture. Double walled cyst with hexagonal inner wall is characteristic of Acanthamoeba. We report a unique case of a 9 year old boy who presented with dense anterior corneal stromal infltration, which on smear examination showed atypical double walled spherical cysts, leading to a diagnostic dilemma. An  ...[more]

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