Case Report

Acanthamoeba Keratitis and Acanthamoeba Conjunctivitis: A Case Report


Acanthamoeba species are vision-threatening agents by causing cornea infections known as Acanthamoeba keratitis. A 5 year-old kid with the complaints of erythema, eyelid edema, inflammation, limitation of eye movements in the right eye, and having no history of wearing contact lenses or trauma, was diagnosed of Acanthamoeba conjunctivitis through laboratory examinations in the Ophthalmology clinic. The visual sharpness of the patient improved after the treatment. A 44 year-old female patient suffering from pain, stinging, irritation, and inability to see in the left eye with the history of wearing contact lenses or trauma was diagnosed of Acanthamoeba keratitis through laboratory examinations. The agent was isolated and identified as "A. castellani" in the Genotype "T2". Examination of the left eye on the 15th day of treatment indicated that all complaints disappeared except for the cataract originated visual loss. However, the first diagnosis of Acanthamoeba keratitis appeared in the literature on a case with no history of wearing contact lenses and trauma it is found to be attention grabbing. We think that Acanthamoeba should not be ignored among microbial agents that cause eye infection with or without trauma and contact lens usage history.

1. Yazar S, Gürbüz E, Sönmez MF, et al. Investiga-tion of potentially pathogenic free-living amoebae and their in vivo pathogenicity in water supplies of Turkey. Mikrobiyol Bul. 2016; 50(3):449-459.
2. Guimaraes AJ, Gomes KX, Cortines JR, et al. Acanthamoeba spp as a universal host for pathogenic microorganisms: one bridge from environment to host virulence. Microbiol Res. 2016; 193:30-38.
3. Knickelbein JE, Kovarik J, Dhaliwal DK,et al. Acan-thamoeba keratitis: A clinic pathologic case report and review of the literature. Hum Pathol. 2013; 44: 918-22.
4. Lorenzo-Morales J, Khan NA, Walochnik J. An update on Acanthamoeba keratitis: diagnosis, patho-genesis and treatment. Parasite. 2015; 22:10.
5. Ibrahim YW, Boase DL, Cree I A. Factors affect-ing the epidemiology of Acanthamoeba keratitis. Ophthalmic Epidemiol. 2007; 14:53–60.
6. Kharousi NSA, Wali UK. Culture Negative Con-foscan Positive Acanthamoeba Keratitis A relentless course. SQU Med J. 2009; 9(3):338-340.
7. Pfister RD, Cameron JD, Krachmer JH, et al. Con-focal microscopy findings of Acanthamoeba keratitis. Am J Ophthalmol. 1996; 121:119-128.
8. Lloyd D. Encystment in Acanthamoeba castellanii: A review. Exp Parasitol. 2014; 145:20-27.
9. Walochnika J, Scheikl U, Haller-Schober EM. Twenty years of Acanthamoeba diagnostics in Aus-tria. J Eukaryot Microbiol. 2015; 3-11.
10. Yeung YY, Huang SC, Tsai RJ. Acanthamoeba Kera-titis Presenting as Dendritic Keratitis in a Soft Con-tact Lens Wearer. Chang Gung Med. 2002; 25(3):201-206.
11. Schroeder JM, Booton GC, Hay J,et al. Use of subgenic 18S ribosomal DNA PCR and sequenc-ing for genus and genotype identification of Acan-thamoebae from humans with keratitis and from sew-age sludge. J Clin Microbiol. 2001; 39(5):1903-1911.
12. Laoprasert T, Kanchanakhan S, Yagıta K, et al. Mo-lecular characterization of an Acanthamoeba sp. ıso-lated from a naturally-infected oscars Astronotus ocel-latus. Aquac Sci. 2010; 58(3):421-424.
13. Fuersta PA, Booton GC, Crary M. Phylogenetic analysis and the evolution of the 18s rRNA gene typing system of Acanthamoeba. J Eukaryot Microbi-ol. 2015; 62:69-84.
14. Orosz E, Farkas Á, Kucsera I. Laboratory diagnosis of Acanthamoeba keratitis in Hungary. Acta Microbiol Immunol Hung. 2016; 63(3):293-299.
15. Gomes Tdos S, Magnet A, Izquierdo F, et al. Acan-thamoeba spp. in Contact Lenses from Healthy Indi-viduals from Madrid, Spain. PLoS One. 2016, 22; 11(4):e0154246.
16. Demirci G, Manav Ay G, Karabas LV, et al. Acan-thamoeba keratitis in a 5-year-old boy without a histo-ry of contact lens usage. Cornea. 2006; 25(3):356-358.
17. Erdem E, Evcil Y, Yagmur M, et al. Non-contact lens use-related Acanthamoeba keratitis in southern Turkey: evaluation of risk factors and clinical fea-tures. Eur J Ophthalmol. 2014; 24(2):164-172.
18. Martinez AJ. Is Acanthamoeba encephalitis an oppor-tunistic infection? Neurology. 1980; 30:567-574.
19. Rivera F, Medina F, Ramirez P, et al. Pathogenic and free-living protozoa cultured from the nasopha-ryngeal and oral regions of dental patients. Environ Res. 1984; 33:428-440.
20. Yünlü Ö, Semra Özçlik S, Arıcı MK. The Investi-gation of Acanthamoeba and Other Free Living Amoeba in Swab Samples Obtained from Con-junctiva and Eye Lid. Turkiye Parazitol Derg. 2015; 39:194-9.
21. Debnath A, Tunac JB, Silva-Olivares A, et al. In vitro efficacy of corifungin against Acanthamoeba cas-tellanii trophozoites and cysts. Antimicrob Agents Chemother. 2014, 58:1523-1528.
22. Anwar A, Siddiqui R, Shah MR,et al. Antidiabetic Drugs and Their Nanoconjugates Repurposed as Novel Antimicrobial Agents against Acanthamoeba castellanii. J Microbiol Biotechnol. 2019, 29(5):713-720.
IssueVol 15 No 2 (2020) QRcode
SectionCase Report(s)
Acanthamoeba conjunctivi-tis Acanthamoeba keratitis Genotype T2

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How to Cite
ALVER O, BAYKARA M, YÜRÜK M, ÜLKÜ TÜZEMEN N. Acanthamoeba Keratitis and Acanthamoeba Conjunctivitis: A Case Report. Iran J Parasitol. 15(2):272-277.