Portal de Periódicos da CAPES

Parasites on the Rise: A New Epidemic of Acanthamoeba Keratitis

2007; Elsevier BV; Volume: 144; Issue: 2 Linguagem: Inglês

10.1016/j.ajo.2007.06.026

1879-1891

Nisha R. Acharya, Thomas M. Lietman, Todd P. Margolis,

Legionella and Acanthamoeba research

Historically, the overwhelming majority of contact lens associated with infectious corneal ulcers in the United States have been attributable to bacteria. 1 Rattanatam T. Heng W.J. Rapuano C.J. Laibson P.R. Cohen E.J. Trends in contact lens-related corneal ulcers. Cornea. 2001; 20: 290-294 Crossref PubMed Scopus (66) Google Scholar , 2 Mah-Sadorra J.H. Yavuz S.G. Najjar D.M. Laibson P.R. Rapuano C.J. Cohen E.J. Trends in contact lens-related corneal ulcers. Cornea. 2005; 24: 51-58 Crossref PubMed Scopus (100) Google Scholar However, over the past two years, two distinct epidemics of contact lens-associated non-bacterial infectious keratitis have been recognized. Last year the Center for Disease Control (CDC) alerted health care providers and consumers of an epidemic of Fusarium keratitis, and just last month they warned of an alarming increase in the number of reported cases of Acanthamoeba keratitis. 3 Update: Fusarium keratitis:United States, 2005 to 2006. MMWR Morb Mortal Wkly Rep. 2006; 55: 563-564 PubMed Google Scholar , 4 Acanthamoeba keratitis multiple states, 2005 to 2007. MMWR Morb Mortal Wkly Rep. 2007; 56: 532-534 PubMed Google Scholar The two outbreaks are disturbingly similar. Both involve patients with recalcitrant keratitis poorly responsive to topical antibiotics and both involve highly publicized voluntary recalls of contact lens solutions. Particularly disturbing is that this is not the first epidemic of Acanthamoeba keratitis linked to the use of contact lens solutions. An outbreak of Acanthamoeba keratitis in the mid-1980s was linked to the use of homemade saline solution. 5 Acanthamoeba keratitis associated with contact lenses: United States. MMWR Morb Mortal Wkly Rep. 1986; 35: 405-408 PubMed Google Scholar With the recent Fusarium and Acanthamoeba outbreaks, multi-purpose contact lens solutions appear to be part of the problem. 3 Update: Fusarium keratitis:United States, 2005 to 2006. MMWR Morb Mortal Wkly Rep. 2006; 55: 563-564 PubMed Google Scholar , 4 Acanthamoeba keratitis multiple states, 2005 to 2007. MMWR Morb Mortal Wkly Rep. 2007; 56: 532-534 PubMed Google Scholar , 6 Chang D.C. Grant G.B. O'Donnell K. et al. Multi-state outbreak of Fusarium keratitis associated with use of a contact lens solution. JAMA. 2006; 296: 953-963 Crossref PubMed Scopus (467) Google Scholar The recent increase in non-bacterial corneal ulcers has raised a number of questions about the etiology, diagnosis, and management of these cases. The Association of Contact Lens Solution Use and Acanthamoeba KeratitisAmerican Journal of OphthalmologyVol. 144Issue 2PreviewTo investigate Acanthamoeba keratitis (AK) risk factors. Diagnosis of AK, a rare but serious corneal infection, has recently increased significantly at the University of Illinois at Chicago (UIC) Cornea Service. Full-Text PDF