ディスポーザブルコンタクトレンズ装用者に生じたアカントアメーバ角膜炎の1例

Acanthamoeba keratitis in a disposable contact lens wearer

　ディスポーザブルタイプのソフトコンタクトレンズを装用していた56歳の白人男性がアカントアメーバ角膜炎を発症した。レンズは朝に装着し，就寝前にはずす終日装用で使用され，夜間は蒸留水中に保存し，消毒は行われていなかった。角膜擦過標本の直接鏡検と培養で　Acanth—amoebaが確認された。フルコナゾール内服，ミコナゾール点眼，および病巣掻爬の3者併用による治療の結果，10週後に角膜中央に淡い混濁を残して治癒した。これらの治療による副作用はなかった。

A 56-year-old Caucasian presented with foreignbody sensation and failing vision in his right eye forthe past 3 months. Topical treatment with antiher-petic agents had reportedly been futile. His visualacuity in the affected eye was reduced to handmotion when first seen by us. He had been a habit-ual wearer of disposable soft contact lens for thepast 2 years. The contact lens was regularlyremoved and put in distilled water during night-time. Otherwise, the lenses were not disinfected andwere discarded after use for 2 weeks. Scraping fromthe corneal lesion showed Acanthamoeba by Parkerink pottasium hydroxide and by culture at 25℃ inthe dark. The lesion was brought to cure after 10weeks by oral fluconazole, topical miconazole andsurgical debridement. No side effects were seenduring the course of treatment.