case_images: PMC4925955_01
case_images: Acanthamoeba keratitis. (A) Photograph depicting the two peripheral corneal-ring infiltrates (arrows) in this patient. (B) Low magnification photomicrograph of H&E stained corneal epithelium scraped from the areas of infiltrates shown in panel (A). A double-walled cyst characteristic of Acanthamoeba is appreciated against the cellular background. (C) Higher magnification views of the cyst at two focal planes demonstrate the presence of the Acanthamoeba exocyst (double arrow head), endocyst (single arrowhead), and nucleolus (arrow).
case_images: CRIOPM2016-4148968.001.jpg
case_images: PMC4925955_01_CRIOPM2016-4148968.001.jpg
case_images: fig1
case_images: The following week, examination showed granularity of the epithelium overlying the ring infiltrates with an increase in stromal inflammation (Figure 1(A)). Acanthamoeba culture and PCR were negative; however, hematoxylin and eosin (H&E) staining of the epithelial smear demonstrated the presence of double-walled cysts typical of Acanthamoeba keratitis (Figure 1, (B) and (C)). Another corneal epithelial debridement was performed and submitted for culture and cytology after 10 weeks of therapy with