Coinfections in contact lens-associated mycotic keratitis with Pseudomonas or Acanthamoeba

Abstract

Contact lens-associated keratitis is becoming increasingly more frequent. Fungal keratitis is a relatively rare clinical picture but must be taken very seriously. Especially in the early stages of the disease, it may be clinically misdiagnosed and adequate treatment is therefore delayed. In treatment-resistant contact lens-associated fungal keratitis, coinfections or superinfections can occur. We present two patients with an initially unclear keratitis, in whom a fungal keratitis with coinfection of Pseudomonas aeruginosa and Acanthamoeba, respectively, could be confirmed. In both cases an urgent excimer laser penetrating keratoplasty with interrupted sutures and adequate local topical treatment for 8 weeks was successful.