Posters

Usefulness of scanning electron microscopy (SEM) in the diagnosis of Acanthamoeba keratitis: case report

Poster Details

First Author: S.Del Prete ITALY

Co Author(s):    A. Del Prete   S. Troisi   M. Troisi   D. Marasco           

Abstract Details

Purpose:

The case of a patient who is not a carrier of LAC, suffering from a corneal abscess, is presented with a waning course despite on-going broad-spectrum therapies; the investigations carried out and the resolutive role of the SEM for the diagnosis are described.

Setting:

In this case, the SEM has proved more effective than the classical techniques, identifying both Acanthamoeba and the presence of pathogens in latency like mycobacteria and micrococci, thus increasing therapeutic efficacy.

Methods:

A 58-year-old woman suffering from a central-paracentral corneal abscess with involvement of the deep stroma. It is subjected to routine examinations (biomicroscopy, microscopic examination in fresh and culture for bacteria and fungi) and in research on viral antigens and Chlamydia with PCR. After practicing a broad-spectrum antimicrobial treatment, with no appreciable result, sampling is carried out for SEM analysis. The SEM method is also used to evaluate the results of the set therapy.

Results:

Biomicroscopy showed a progressive extension of the pathology, despite a broad-spectrum antibiotic / antiseptic therapy. Bacterioscopic examination, culture and PCR on tears gave negative results. SEM showed active Acanthamoeba cysts, so therapy with PHMB and chlorhexidine was undertaken. The 30-day SEM control showed disappearance of cysts and the presence of mycobacteria and micrococci; the subsequent treatment resulted in complete regression of inflammation.

Conclusions:

The use of SEM has proved to be decisive, in the case in question, to highlight the Acanthamoeba infection. This method has also proved invaluable for assessing the efficacy of therapy and subsequent mycobacterial superinfection.

Financial Disclosure:

... gains financially from competing product or procedure, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company, ... has significant investment interest in a company producing, developing or supplying product or procedure presented