[Acanthamoeba keratitis: report of 3 cases diagnosed in central Tunisia]

Amoeba of the genus Acanthamoeba are ubiquitous free-living protozoa encountered in water and soil. They frequently cause sight-threatening keratitis. Report of the three first cases diagnosed at the laboratory of Parasitology of Sousse Hospital. [Tunisia]. Our study concerned three lens-wearing female patients. aged 17, 20 and 29 years respectively. The patients originate from central Tunisia and presented with unilateral [2 cases] or bilateral [one case] keratitis. Diagnosis was made by demonstrating Acanthamoeba trophozoites and/or cysts on direct examination and/or culture [in agar-Escherichia coli medium] of contact lenses and/or lenses' solution. Direct examination of corneal swabs was negative in three cases but culture was positive in one. The three patients were treated with hexamidine and neomycine eye-drops for three months. Treatment led to scarring of lesions with however sequellar opacities that was minor to moderate in two cases and consisted of a central leucoma with a poor visual outcome in the last case. The need for systematic research of amoeba in lenses wearing patients with keratitis is emphasized