Your browser doesn't support javascript.
loading
Acanthamoeba keratitis in Mexico: Report of a clinical case and importance of sensitivity assays for a better outcome.
Omaña-Molina, Maritza; Vanzzini-Zago, Virginia; Hernández-Martínez, Dolores; Reyes-Batlle, María; Castelan-Ramírez, Ismael; Hernández-Olmos, Perla; Salazar-Villatoro, Lizbeth; González-Robles, Arturo; Ramírez-Flores, Elizabeth; Servín-Flores, Christopher; Flores-Alvarado, Víctor; Alcántara-Castro, Marino; Lorenzo-Morales, Jacob.
Afiliación
  • Omaña-Molina M; Faculty of Superior Studies Iztacala, UNAM. Tlalnepantla, State of Mexico, Mexico. Electronic address: maritzaomanam@yahoo.com.mx.
  • Vanzzini-Zago V; Hospital Para Evitar la Ceguera en México, "Luis Sánchez Bulnes", Mexico.
  • Hernández-Martínez D; Faculty of Superior Studies Iztacala, UNAM. Tlalnepantla, State of Mexico, Mexico.
  • Reyes-Batlle M; University Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, Tenerife, Canary Island, Spain.
  • Castelan-Ramírez I; Faculty of Superior Studies Iztacala, UNAM. Tlalnepantla, State of Mexico, Mexico.
  • Hernández-Olmos P; Faculty of Superior Studies Iztacala, UNAM. Tlalnepantla, State of Mexico, Mexico.
  • Salazar-Villatoro L; Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies, Mexico City, Mexico.
  • González-Robles A; Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies, Mexico City, Mexico.
  • Ramírez-Flores E; Faculty of Superior Studies Iztacala, UNAM. Tlalnepantla, State of Mexico, Mexico.
  • Servín-Flores C; Faculty of Superior Studies Iztacala, UNAM. Tlalnepantla, State of Mexico, Mexico.
  • Flores-Alvarado V; Hospital Para Evitar la Ceguera en México, "Luis Sánchez Bulnes", Mexico.
  • Alcántara-Castro M; Hospital Para Evitar la Ceguera en México, "Luis Sánchez Bulnes", Mexico.
  • Lorenzo-Morales J; University Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, Tenerife, Canary Island, Spain.
Exp Parasitol ; 196: 22-27, 2019 Jan.
Article en En | MEDLINE | ID: mdl-30472333
Acanthamoeba keratitis (AK) is a sight-threatening corneal infection. The early symptoms include redness, pain, photophobia and intense tearing. Chronic infection usually progresses to stromal inflammation, ring ulcers, corneal opacification and hypopyon. Here we document an AK case in a high myopic 38-year-old woman from Mexico City, with a history of wearing contact lenses while swimming. Corneal scrapes cultures were positive only for amoebae, consequently a treatment including netilmicin 0.3% and oral itraconazole 100 mg/12 h was prescribed. The infection was resolved after 8 months, leaving a slight leucoma outside the visual axis, with a visual acuity of 20/150. In the laboratory, the amoebic isolate was axenized in PYG medium, with an optimal growth at 30 °C, and was identified morphologically as Acanthamoeba polyphaga according to the taxonomic criteria of Page (1988) and placed in the T4 group by genotyping. The virulence of this strain (40%) was determined by intranasal inoculation of 1 × 106/20 µl trophozoites in BALB/c mice recovering from brain, proving their invasion ability and by the interaction with monolayers of epithelial cells of the established MDCK line of canine kidney origin (1:2 ratio of interaction), at 1, 3, 6, 8 and 24 h; trophozoites migrated to cell junctions inducing few lytic zones. In addition to the biological characterization, in vitro drug sensitivity tests were performed using chlorhexidine, itraconazole, netilmicin and voriconazole. Results revealed that voriconazole was the most effective compound. A. polyphaga remains as one of the most frequently isolated species producing AK. The treatment of AK case using netilmicin and oral itraconazole solved the disease, but the healing process was wide-ranging (8 months). The use of voriconazole and chlorhexidine may be an alternative treatment of future AK cases in Mexico.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acanthamoeba / Queratitis por Acanthamoeba / Antiinfecciosos Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adult / Animals / Female / Humans País/Región como asunto: Mexico Idioma: En Revista: Exp Parasitol Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acanthamoeba / Queratitis por Acanthamoeba / Antiinfecciosos Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adult / Animals / Female / Humans País/Región como asunto: Mexico Idioma: En Revista: Exp Parasitol Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos