ACANTHAMOEBA-KERATITIS WITH GRANULOMATOUS REACTION INVOLVING THE STROMA AND ANTERIOR-CHAMBER

Most cases of granulomatous reaction to Descemet membrane are caused b y disciform herpes simplex and mycotic keratitis. To our knowledge, a clinicopathologic report of Acanthamoeba species infection has not bee n documented. We used standard histopathologic techniques, including l ight microscopy with special stains and indirect immunofluorescence. A granulomatous reaction with many multinucleated giant cells, some of which engulfed cysts of Acanthamoeba species, was present in the poste rior corneal stroma and anterior chamber along the plane of Descemet m embrane. A severe, acute, suppurative inflammatory response and areas of stromal necrosis also were present. The diagnosis of Acanthamoeba c astellanii was confirmed by immunofluorescent studies. A granulomatous reaction to Descemet membrane and/or the corneal stroma may represent a specific tissue response to various infectious agents. Keratitis ca used by Acanthamoeba species may be added to herpes simplex stromal ke ratitis and mycotic keratitis as a causative organism capable of produ cing a granulomatous reaction involving the stroma and anterior chambe r.