[Amoebae of the genus Acanthamoeba--causative agents of human infections]. / Menavky rodu Acanthamoeba--pôvodcovia infekcií cloveka.

Amoebae of the genus Acanthamoeba Volkonsky, 1931 are ubiquitous, amphizoic organisms with a cosmopolitan distribution. Pathogenic strains are the causative agents of a difficult to treat disease, granulomatous amoebic encephalitis (GAE), and skin infections in immunocompromised individuals, and of a painful corneal disease--amoebic keratitis (AK) in immunocompetent individuals. The major portals of entry are the nasopharyngeal mucosa, pulmonary parenchyma, skin lesions (GAE, skin infections), eyes in contact lenses wearers with a history of improper contact lens wear and care, or corneal trauma (AK). Symptoms of the diseases are non-specific and variable which alongside with the lack of awareness among health care professionals often hamper early diagnosis. While treatment options for GAE and skin infections are limited and poorly effective, various antifungals and antimicrobials have proved beneficial in AK, although the therapy is often complicated and long.

[Impingement of an accessory intraabdominal organ as an uncommon intraoperative diagnosis--a case review]. / Uskrinutí akcesorního orgánu brisní dutiny jako neobvyklá peroperacní diagnóza - kazuistika.

In this case report is described a patient with an abdominal pain, who came to surgery. Intraoperatively was found the infarcted formation of unknown origin in the omentum--suspicion of accessory spleen. Histologically was elucidated, that the formation consisted of ischemic adipose tissue--there was a torsion of a large caul.

Weak cytotoxic activity of miltefosine against clinical isolates of Acanthamoeba spp.

Hexadecylphosphocholine (miltefosine) is an anticancer drug active in vitro against various protozoan parasites, and recently used for the treatment of disseminated Acanthamoeba infection. In the present study, we present results of weak cytotoxic activity of this potential amoebicidal agent for 2 of 3 clinical isolates of Acanthamoeba spp. Although the inhibition effect for all tested concentrations was apparent, and showed 100% eradication of trophozoites of Acanthamoeba castellanii strain at a concentration of 62.5 µM after 24 hr, the strains Acanthamoeba sp. and Acanthamoeba lugdunensis exhibited low sensitivity to hexadecylphosphocholine, even in high concentrations. The determined minimal trophocidal concentrations were 250 µM for Acanthamoeba sp. and 500 µM for A. lugdunensis after 24 hr of exposure. Although hexadecylphosphocholine is a potential agent for treatment of Acanthamoeba keratitis and systemic infections, in clinical practice the possible insusceptibility of the amoebic strain should be considered for optimizing therapy.

[Acanthamoeba keratitis after use of soft contact lenses--case report]. / Acanthamoebová keratitis po aplikácii mäkkých kontaktných sosoviek--kazuistika.

The case history of a 39-year patient suffering from a deep inflammation of cornea and not responding to conventional antibiotic treatment is presented. The patient was using soft contact lenses during the period of initial symptoms; moreover, he was bathing in thermal bathing pool. A cultivation examination of smears from the area of corneal defect revealed the presence of Acanthamoeba lugdunensis in combination with bacterial infection by Pseudomonas aeruginosa. The available data indicate that it is the first case of acanthamoeba karatitis (AK) after the application of contact lenses in Slovakia. A long-term local treatment with propamidin isethionate (Brolene gtt, ung.) resulted in healing up. The subsequent vision after 16 months since the initial symptoms proved to be 6/12 (0.5). The healing of the centrally localized defect changed the curvature of cornea with consequent hypermetropic shift. The defect completely corrected the patient's myopia (-8.5). The paper describes present possibilities of AK therapy.