Challenges in Acanthamoeba keratitis - treatment efficacy of a sight-threatening disease in a severe case without identified risk factors requiring diagnostic verification.

Acanthamoeba keratitis (AK), the vision-threatening disease caused by the amphizoic, potentially parasitic amoebae is growing threat for public health in Poland and worldwide. The report presents the case of 70-year-old man with severe keratitis admitted to an Ophthalmology Clinic. Before admission, the patient had been treated for 6 months with antibacterial and antifungal drugs in other units, without improvement in the eye condition. The use of in vivo confocal microscopy and in vitro cultivation allowed diagnosis to be verified and AK successfully treated. Awareness of the threat to public health caused by Acanthamoeba spp is still insufficient. If there is failure in response to first line therapy, AK should be taken into account,despite the lack of identified risk factors. In vitro monitoring of amoebic strain can be helpful for prognosis of the course of the corneal disease. Improvement in duration from first symptoms until proper diagnosis is decisive for better treatment efficacy.