Can Acanthamoeba keratitis be properly diagnosed without culture in the real-world clinical microbiology laboratory?: a case report
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Acanthamoeba species are ubiquitous, free-living organisms found in the environment. Theycan cause a sight-threatening cornea disease, termed Acanthamoeba keratitis, and are oftenmisdiagnosed, causing delayed administration of the correct treatment. Herein, we report acase of Acanthamoeba keratitis diagnosed without culture. A 12-year-old girl with a historyof wearing contact lenses presented with complaints of pain, irritation, and hyperemia in theleft eye. Corneal scraping-smeared slide, and liquids with contact lenses were submitted tothe clinical microbiology laboratory. Cultures of Acanthamoeba spp. were not available; thus,they were stained with calcofluor white. The isolation of Acanthamoeba from the cornealscraping allowed the detection of trophozoites and cysts based on their morphologicalcharacteristics. PCR targeting the 18s rRNA gene and subsequent sequencing revealed 99%identity with the Acanthamoeba spp. Although it is challenging to find real-world evidence ofAcanthamoeba in clinical microbiology without using culture methods, this case underscoresthe need for clinical microbiology laboratories to maintain their inspection capabilities.
Abstract
Acanthamoeba species are ubiquitous, free-living organisms found in the environment. Theycan cause a sight-threatening cornea disease, termed Acanthamoeba keratitis, and are oftenmisdiagnosed, causing delayed administration of the correct treatment. Herein, we report acase of Acanthamoeba keratitis diagnosed without culture. A 12-year-old girl with a historyof wearing contact lenses presented with complaints of pain, irritation, and hyperemia in theleft eye. Corneal scraping-smeared slide, and liquids with contact lenses were submitted tothe clinical microbiology laboratory. Cultures of Acanthamoeba spp. were not available; thus,they were stained with calcofluor white. The isolation of Acanthamoeba from the cornealscraping allowed the detection of trophozoites and cysts based on their morphologicalcharacteristics. PCR targeting the 18s rRNA gene and subsequent sequencing revealed 99%identity with the Acanthamoeba spp. Although it is challenging to find real-world evidence ofAcanthamoeba in clinical microbiology without using culture methods, this case underscoresthe need for clinical microbiology laboratories to maintain their inspection capabilities.
참고문헌 (11)
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