Taiwan Journal of Ophthalmology

CASE REPORT
Year
: 2019  |  Volume : 9  |  Issue : 2  |  Page : 131--133

Dendrite-like anterior stromal keratitis coinfected with Acanthamoeba and Pseudomonas in an orthokeratology contact lens wearer


Chih-Chien Hsu 
 Department of Ophthalmology, Taipei Veterans General Hospital; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

Correspondence Address:
Dr. Chih-Chien Hsu
Department of Ophthalmology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112
Taiwan

Acanthamoeba species can cause a keratitis misdiagnosed as herpes keratitis or fungal keratitis. We report an unusual dendrite-like anterior stromal keratitis coinfected with Acanthamoeba and Pseudomonas aeruginosa in an orthokeratology contact lens wearer in Taiwan. Topical 1% voriconazole and 0.5% levofloxacin were prescribed because besides Acanthamoeba keratitis, fungal keratitis was also highly suspected initially. Topical 0.02% chlorhexidine was added after the culture of the scraped cornea showed positive results of Acanthamoeba and P. aeruginosa. The lesion subsided using this triple combination therapy for 1 week. Both Acanthamoeba and P. aeruginosa are potentially devastating causes of infectious keratitis. Our case highlights the importance of considering the possibility of a concurrent infection and atypical presentation in cases with contact lens-related keratitis. The use of topical levofloxacin combined with voriconazole should be considered as the first-line treatment in such patients.


How to cite this article:
Hsu CC. Dendrite-like anterior stromal keratitis coinfected with Acanthamoeba and Pseudomonas in an orthokeratology contact lens wearer.Taiwan J Ophthalmol 2019;9:131-133


How to cite this URL:
Hsu CC. Dendrite-like anterior stromal keratitis coinfected with Acanthamoeba and Pseudomonas in an orthokeratology contact lens wearer. Taiwan J Ophthalmol [serial online] 2019 [cited 2021 Sep 21 ];9:131-133
Available from: https://www.e-tjo.org/article.asp?issn=2211-5056;year=2019;volume=9;issue=2;spage=131;epage=133;aulast=Hsu;type=0