eMedicine Specialties > Infectious Diseases > Parasitic Infections

Acanthamoeba: Follow-up

Author: Nancy F Crum-Cianflone, MD, Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Naval Medical Center at San Diego; HIV Research Physician, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
Contributor Information and Disclosures

Updated: Jun 30, 2008

Follow-up

Deterrence/Prevention

  • Keratitis
    • Avoid using homemade sodium chloride solutions and swimming while wearing contacts.
    • Follow manufacturer's guidelines regarding cleaning contact lenses.
    • Heat disinfect or use benzalkonium-preserved saline for cleaning contact lenses.

Complications

  • Keratitis
    • Hypopyon
    • Cataracts
    • Loss of vision
  • Granulomatous amebic encephalitis
    • Seizures
    • Coma
    • Death

Prognosis

  • Keratitis usually responds to medical therapy. The disease process may affect visual acuity.
  • GAE carries a high mortality rate (nearly 100%). Most cases are fatal in 7-120 days (mean, 39 d).
  • Disseminated disease with skin involvement (no CNS disease) is associated with a mortality rate (73%).

Patient Education

  • Contact lens wearers should avoid using homemade sodium chloride solutions and swimming while wearing contact lenses. Patients should consult manufacturer's guidelines regarding cleaning instructions.

Miscellaneous

Medicolegal Pitfalls

  • Keratitis
    • Failure to consider Acanthamoeba in the differential diagnoses of keratitis and to obtain the appropriate diagnostic studies to evaluate for this condition
    • Failure to instruct patients regarding proper contact lens–cleaning procedures
    • Failure to advise patients to avoid swimming with lenses
    • Failure to advise patients to not use homemade sodium chloride solutions
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor William B. Harley, MD, to the development and writing of this article.



More on Acanthamoeba

Overview: Acanthamoeba
Differential Diagnoses & Workup: Acanthamoeba
Treatment & Medication: Acanthamoeba
Follow-up: Acanthamoeba
References
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References

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Further Reading

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Keywords

Acanthamoeba, Acanthamoeba castellanii, A castellanii, Acanthamoeba polyphaga, A polyphaga, Acanthamoeba culbertsoni, A culbertsoni, Acanthamoeba palestinensis, A palestinensis, Acanthamoeba astronyxis, A astronyxis, Acanthamoeba hatchetti, A hatchetti, Acanthamoeba rhysodes, A rhysodes, Acanthamoeba divionensis, A divionensis, Acanthamoeba quna, A quna, Acanthamoeba lugdunensis, A lugdunensis, Acanthamoeba griffini, A griffini,Naegleria, Balamuthia, acanthamebic infection, keratitis in contact lens wearers, granulomatous amebic encephalitis, GAE, disseminated disease, free-living amoebas, disseminated granulomatous amebic disease, amebic keratitis, Acanthamoeba keratitis

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Contributor Information and Disclosures

Author

Nancy F Crum-Cianflone, MD, Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Naval Medical Center at San Diego; HIV Research Physician, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
Nancy F Crum-Cianflone, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Medical Editor

David Hall Shepp, MD, Program Director, Fellowship in Infectious Diseases, Department of Medicine, North Shore University Hospital; Associate Professor, New York University School of Medicine
David Hall Shepp, MD is a member of the following medical societies: Infectious Diseases Society of America
Disclosure: Gilead Sciences Salary Management position

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Richard B Brown, MD, FACP, Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine
Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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