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Published 14 April 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.08.2008.0642]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Rare disease

Unusual case of methicillin resistant staphylococcus aureus and acanthamoeba keratitis in a non-contact lens wearer from Kashmir, India

Rubina Lone1, Khurshid Syed1, Rashid Abdul1, Sajjad Ahmed Sheikh2, Faisal Shah2

1 SKIMS Medical College, Microbiology, Bemina, Srinagar, 190017, India
2 SKIMS Medical College, Ophthalmology, Bemina, Srinagar, Jammu & Kashmir, 190017, India

Correspondence to:
Rubina Lone, dr.rubina.lone{at}gmail.com

SUMMARY

Acanthamoeba species can cause a chronic, progressive, ulcerative keratitis of the eye, which is not responsive to the usual antimicrobial treatment and is frequently mistaken for stromal herpes keratitis. Acanthamoeba keratitis continues to be a burgeoning and unsolved problem. Although soft contact lens wear is reported as the major risk factor in other parts of the world, reports from India suggest that acanthamoeba keratitis is more common among non-contact lens wearers. An unusual case of coinfection with Acanthamoeba and methicillin resistant staphylococcus aureus (MRSA) as causes of corneal keratitis in a contact lens wearer from Kashmir, India, is reported. Recent findings have shown that MRSA uses amoebae to spread, sidestepping hospital and other protection measures. Cysts of the isolated Acanthamoeba tolerated an incubation temperature of 40°C, indicating a pathogenic species. This case highlights the importance of culture methods in the diagnosis of corneal infection and the choice of treatment regimen.


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