Vermamoeba vermiformis as the etiological agent in a patient with suspected non-Acanthamoeba keratitis

IF 1.8 3区 医学 Q2 PARASITOLOGY Parasitology Research Pub Date : 2024-09-10 DOI:10.1007/s00436-024-08347-2
Mehmet Aykur, Ozlem Barut Selver, Hande Dagci, Melis Palamar
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Abstract

Vermamoeba vermiformis (V. vermiformis) is one of the most common free-living amoeba (FLA) and is frequently found in environments such as natural freshwater areas, surface waters, soil, and biofilms. V. vermiformis has been reported as a pathogen with pathogenic potential for humans and animals. The aim is to report a case of non-Acanthamoeba keratitis in which V. vermiformis was the etiological agent, identified by culture and molecular techniques. Our case was a 48-year-old male patient with a history of trauma to his eye 10 days ago. The patient complained of eye redness and purulent discharge. A slit-lamp examination of the eye revealed a central corneal ulcer with peripheral infiltration extending into the deep stroma. The corneal scraping sample taken from the patient was cultured on a non-nutritious agar plate (NNA). Amoebae were evaluated according to morphological evaluation criteria. It was investigated by PCR method and confirmed by DNA sequence analysis. Although no bacterial or fungal growth was detected in the routine microbiological evaluation of the corneal scraping sample that was cultured, amoeba growth was detected positively in the NNA culture. Meanwhile, Acanthamoeba was detected negative by real-time PCR. However, V. vermiformis was detected positive with the specific PCR assay. It was confirmed by DNA sequence analysis to be considered an etiological pathogenic agent. Thus, topical administration of chlorhexidine gluconate %0.02 (8 × 1) was initiated. Clinical regression was observed 72 h after chlorhexidine initiation, and complete resolution of keratitis with residual scarring was noticed in 5 weeks. In conclusion, corneal infections due to free-living amoebae can occur, especially in poor hygiene. Although Acanthamoeba is the most common keratitis due to amoeba, V. vermiformis is also assumed to associate keratitis in humans. Clinicians should also be aware of other amoebic agents, such as V. vermiformis, in keratitis patients.

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一名疑似非阿卡他米巴角膜炎患者的致病原蛭子
蛭形阿米巴(V. vermiformis)是最常见的自由生活阿米巴(FLA)之一,经常出现在自然淡水区域、地表水、土壤和生物膜等环境中。据报道,蛭形阿米巴虫是一种对人类和动物具有潜在致病性的病原体。本文旨在报告一例非阿卡他米巴角膜炎病例,通过培养和分子技术鉴定,蛭形体是该病原体。我们的病例是一名 48 岁的男性患者,10 天前他的眼睛有外伤史。患者主诉眼睛发红并有脓性分泌物。眼部裂隙灯检查发现角膜中央溃疡,周边浸润延伸至深层基质。在无营养琼脂平板(NNA)上对患者的角膜刮取样本进行了培养。根据形态学评估标准对阿米巴进行评估。通过聚合酶链反应(PCR)方法对阿米巴进行检测,并通过 DNA 序列分析加以确认。虽然在对角膜刮片样本进行常规微生物学评估时未检测到细菌或真菌生长,但在 NNA 培养中检测到阿米巴生长呈阳性。同时,通过实时 PCR 检测,棘阿米巴呈阴性。然而,通过特异性聚合酶链式反应(PCR)测定,检测到荚膜蛭石呈阳性。经 DNA 序列分析证实,它是一种致病病原体。因此,开始局部使用葡萄糖酸氯己定 0.02%(8×1)。开始使用洗必泰 72 小时后,临床症状有所缓解,5 周后角膜炎完全消退,但仍有瘢痕残留。总之,游离阿米巴原虫可引起角膜感染,尤其是在卫生条件较差的情况下。虽然阿米巴原虫是最常见的角膜炎原虫,但蛭形阿米巴原虫也可能引起人类角膜炎。临床医生还应注意角膜炎患者中的其他阿米巴原虫,如蛭形病毒。
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来源期刊
Parasitology Research
Parasitology Research 医学-寄生虫学
CiteScore
4.10
自引率
5.00%
发文量
346
审稿时长
6 months
期刊介绍: The journal Parasitology Research covers the latest developments in parasitology across a variety of disciplines, including biology, medicine and veterinary medicine. Among many topics discussed are chemotherapy and control of parasitic disease, and the relationship of host and parasite. Other coverage includes: Protozoology, Helminthology, Entomology; Morphology (incl. Pathomorphology, Ultrastructure); Biochemistry, Physiology including Pathophysiology; Parasite-Host-Relationships including Immunology and Host Specificity; life history, ecology and epidemiology; and Diagnosis, Chemotherapy and Control of Parasitic Diseases.
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