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Indian J Ophthalmol. 2019 Nov;67(11):1886-1888. doi: 10.4103/ijo.IJO_2019_18.

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

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


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.


Acanthamoeba; gene sequencing; keratitis


Conflict of interest statement

There are no conflicts of interest.

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