Dictyostelium polycephalum Infection of Human Cornea

Acute encephalopathy coincident with seroconversion for anti-HTLV-III. 2. Centers for Disease Control and Prevention. Neurologic complications associated with novel infl uenza A (H1N1) virus in-A (H1N1) presenting as an acute febrile encephalopathy in a mother and daughter. The level of human immunodefi ciency virus (HIV) type 1 RNA in cerebrospinal fl uid as a marker of HIV encephalitis.nostic importance of relative lymphopenia as a marker of swine infl uenza (H1N1) in adults. It's not all swine fl u…are we missing opportunities to diagnose primary HIV infection in patients with fl u symptoms? Int J STD To the Editor: Although Dictyos-telium spp. are used for studying signal transduction, cytoskeletal functions, endocytosis, and molecular pathogen-esis of infectious and other diseases (1), human or animal infections caused by this organism have not been reported. We report a case of keratitis caused by Dictyostelium polycephalum in an im-munocompetent person. A 35-year-old man sought treatment for redness, pain, and watering in the left eye of 11 days' duration. He had no history of ocular injury or surgery. At the time of his medical visit, he was using ophthalmic solutions of 5% natamycin sulfate, 0.5% moxifl ox-acin hydrochloride, and 0.3% gentam-icin sulfate, each instilled every hour, and 1% atropine sulfate, 3×/d. The vision in his right eye and results of a clinical examination were within normal limits. His left eye visual acuity was expressed as the ability to count fi ngers at 1 m. The eyelids were edematous and the conjunctivae were congested. The cornea showed a large central epithelial defect with underlying stromal infi ltrate and De-scemet folds. The surrounding cornea had a mild cellular reaction. The anterior chamber was deep, and the pupil was round, regular, and dilated. Iris and lens details could not be distinguished because of corneal haze. We obtained corneal scrapings, and the material was subjected to a detailed microbiologic analysis (2). Microscopic examination showed double-walled spherical cysts in potassium hydroxide with calcofl uor white stain, Gram stain (Figure, panels A, B), and Giemsa stain. On the basis of this fi nding, a presumptive diagnosis of Acanthamoeba keratitis was made. The patient was advised to use 0.02% polyhexamethylene biguanide and 0.02% chlorhexidine eye drops every half hour and 1% atropine eye drops 3×/d and was asked to return for a follow-up visit the next day. However, the patient did not return and could not be located. After 48 hours' of incubation …