Клинический случай акантамёбного кератита. Трудности диагностики и лечения

Abstract

Acanthamoebic keratitis (AK) is a serious disease caused by the simplest acanthamoeba. Often it is associated with the wearing of contact lenses (CL) (80 –90 %). The article describes a clinical case of AK of both eyes associated with wearing soft contact lenses (MCL). The diagnosis was based on the patient's complaints, medical history and clinical presentation. Treatment was performed both topically and systemically and long-term follow-up on an outpatient basis. As a result, the active inflammatory process was stopped. Subsequently, in a calm period, the patient underwent through keratoplasty, reconstruction of the anterior chamber of the right eye. At the moment, the patient's vision allows him to lead a full life without any restrictions. Conclusions were drawn from this example: 1) determining the etiology of keratitis is extremely difficult; 2) CL users are obliged to know the risks and rules of wearing CL; 3) AK treatment is a long, difficult, not always successful and experimental process. The issue of patient routing and timely operative treatment under the compulsory health insurance system remains relevant. Keywords: аcantamoeba, acanthamoebic keratitis, clinical case, contact lenses, drug treatment