Journal d'ophtalmologie clinique et expérimentale
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A Case of Atypical Acanthamoeba Keratitis with Cruciate Stromal Infiltration

Yeon Soo Kang, Hyo Seok Lee, Won Choi and Kyung Chul Yoon

Purpose: To report a case of atypical Acanthamoeba keratitis (AK) with cruciate stromal infiltration, which was successfully treated.
Case report: A 16-year-old woman with a history of intermittent soft contact lens wear was referred to our eye center. At presentation, her best-corrected visual acuity (BCVA) was 3/20 in the right eye. Slit lamp examination showed irregular epithelial infiltration, and mild edema in the cornea of the right eye. Topical antibiotics and antiviral agents were applied. After 1 week, her BCVA in the right eye decreased to counting fingers and epithelial infiltration was aggravated. Diffuse cruciate stromal infiltration newly developed. Under the presumptive diagnosis of AK, topical antibiotics and antiviral agents were stopped, and topical 0.02% chlorhexidine was started. After 2 weeks of treatment, the stromal infiltration decreased and culture was positive for Acanthamoeba species. After 3 months of treatment, the cornea was clear and her BCVA was 20/20 in the right eye.
Conclusions: Atypical AK can present as cruciate stromal infiltration and can be treated successfully with topical 0.02% chlorhexidine.