18S rDNA sequencing aided diagnosis of Acanthamoeba jacobsi keratitis -A case report
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Date
2019-11
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Publisher
All India Ophthalmological Society
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.
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Keywords
Acanthamoeba, gene sequencing, keratitis
Citation
Singh A, Acharya M, Jose N, Gandhi A, Sharma S. 18S rDNA sequencing aided diagnosis of Acanthamoeba jacobsi keratitis -A case report. Indian Journal of Ophthalmology. 2019 Nov; 67(11): 1886-1888