Clinical analysis of combined fungal and acanthamoeba keratitis

Abstract

Objective To study the etiology, clinical features, diagnosis and treatment of patients with combined fungal and acanthamoeba kerafitis.Methods Nineteen cases of combined fungal and acanthamoeba keratitis at the First Affiliated Hospital of Fujian Medical University between July 2007 and May 2008 were retrospectively reviewed.Predisposing factors, diagnosis, and clinical characteristics of the patients were analyzed. The patients were received medications or conjunctival flap covering or penetrating keratoplasty (PKP).Results Patients in this series, risk factors included corneal trauma (14/19) and contact lens wear (3/19).Patients were confirmed by corneal scraping and microscopic examination, and/or fungal/amoeba culture.Sixteen cases were showed corneal local ulcer, and 3 cases were ring-shaped stromal infiltration. Five cases were cured by combined anti-amoeba and anti-fungal drug therapy, and 11 patients were healed by conjunctival flap covering, and 2 patients performed PKP.Conclusions The main risk factor of combined fungal and acanthamoeba keratitis is corneal trauma.Scraping and microscopic examination is an effective method for early diagnosis.Anti-amoeba/fungal drug therapy combined with conjunctival flap covering is an effective method to treat this keratitis. Key words: Keratitis; Acanthamoeba; Fungal; Combined Infection