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CASE REPORT
Year : 2019  |  Volume : 67  |  Issue : 11  |  Page : 1886-1888

18S rDNA sequencing aided diagnosis of Acanthamoeba jacobsi keratitis -A case report


1 Dr. Shroff's Charity Eye Hospital, New Delhi, India
2 Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India

Correspondence Address:
Dr. Aastha Singh
Dr.Shroff's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2019_18

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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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