Outbreak of keratitis presumed to be caused by Acanthamoeba

William Mathers, J. E. Sutphin, R. Folberg, P. A. Meier, R. P. Wenzel, R. G. Elgin

Research output: Contribution to journalArticle

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Abstract

PURPOSE: A sharp increase of Acanthamoeba keratitis from two cases per year to 30 cases per year at our institution prompted this study to determine whether there was a change in the clinical characteristics, basic epidemiology, and outcome of this disease. METHODS: We reviewed all cases of Acanthamoeba keratitis diagnosed at the University of Iowa Hospitals and Clinics from mid-1993 through 1994. RESULTS: We screened 217 patients with keratitis by tandem scanning confocal microscopy and suspected Acanthamoeba in 51 patients. Diagnosis was confirmed by cytology in 43 patients (48 eyes). There were no positive cultures. Patients examined within four weeks of onset of symptoms were younger (mean age, 32.6 ± 15.4 years) and wore contact lenses (11 of 18 patients), and infrequently herpes simplex keratitis (four of 18 patients) was diagnosed. Patients examined after four weeks were older (mean age, 54.0 ± 19.5 years), infrequently wore contact lenses (six of 25 patients), and often had herpes simplex keratitis (12 of 25 patients). CONCLUSIONS: Corneal examination with tandem scanning confocal microscopy was associated with a marked increase in the detection of Acanthamoeba, strongly suggesting that the disease is more prevalent than suspected. Acanthamoeba may account for many cases of clinically presumed herpes simplex keratitis, the leading cause of corneal blindness in the United States. Acanthamoeba should be considered in the differential diagnosis of any unexplained keratitis, even those of short duration.

Original languageEnglish (US)
Pages (from-to)129-142
Number of pages14
JournalAmerican Journal of Ophthalmology
Volume121
Issue number2
StatePublished - 1996
Externally publishedYes

Fingerprint

Acanthamoeba
Keratitis
Disease Outbreaks
Herpetic Keratitis
Acanthamoeba Keratitis
Contact Lenses
Confocal Microscopy
Blindness
Cell Biology
Epidemiology
Differential Diagnosis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Mathers, W., Sutphin, J. E., Folberg, R., Meier, P. A., Wenzel, R. P., & Elgin, R. G. (1996). Outbreak of keratitis presumed to be caused by Acanthamoeba. American Journal of Ophthalmology, 121(2), 129-142.

Outbreak of keratitis presumed to be caused by Acanthamoeba. / Mathers, William; Sutphin, J. E.; Folberg, R.; Meier, P. A.; Wenzel, R. P.; Elgin, R. G.

In: American Journal of Ophthalmology, Vol. 121, No. 2, 1996, p. 129-142.

Research output: Contribution to journalArticle

Mathers, W, Sutphin, JE, Folberg, R, Meier, PA, Wenzel, RP & Elgin, RG 1996, 'Outbreak of keratitis presumed to be caused by Acanthamoeba', American Journal of Ophthalmology, vol. 121, no. 2, pp. 129-142.
Mathers W, Sutphin JE, Folberg R, Meier PA, Wenzel RP, Elgin RG. Outbreak of keratitis presumed to be caused by Acanthamoeba. American Journal of Ophthalmology. 1996;121(2):129-142.
Mathers, William ; Sutphin, J. E. ; Folberg, R. ; Meier, P. A. ; Wenzel, R. P. ; Elgin, R. G. / Outbreak of keratitis presumed to be caused by Acanthamoeba. In: American Journal of Ophthalmology. 1996 ; Vol. 121, No. 2. pp. 129-142.
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