Sunday, November 17, 2013

Answer to Case 282

Answer:  Amebic keratitis due to Acanthamoeba species.  The double-walled cysts and trophozoites are characteristic:

Unfortunately this patient ended up undergoing 2 corneal transplants before she finally was cleared of infection.  She now has near normal vision.  Amebic keratitis can be very difficult to treat, since the presence of a single residual cyst is enough to allow for reactivation of infection after treatment or surgery.

Greater than 90% of cases in the U.S. are associated with contact lens use, as was the case with this patient.

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