Keratitis: The Daily PANCE Blueprint
A contact lens wearer has acute bacterial keratitis. Which of the following is the most likely causative organism?
A. Pseudomonas aeruginosa
B. Moraxella lacunata
C. Streptococcus pneumoniae
D. Escherichia coli
E. Nocardia brasiliensis
Answer and topic summary
The answer is A. Pseudomonas aeruginosa
Infectious keratitis can be a serious complication of contact lens usage. Bacterial keratitis is the most common of all contact lens infections and occurs predominantly due to Pseudomonas. Other implicated bacteria are Staphylococcus and Streptococcus. Clinical features include red, painful eye, eyelid swelling, & photophobia. The definitive diagnosis is made via slit lamp exam – which should reveal a corneal epithelial defect with underlying stromal infilrates. Urgent ophthalmologic referral should be made; the patient should be started on empiric antibiotics (e.g., moxifloxacin, gatifloxacin, OR cefazolin + gentamicin or tobramycin). Steroids should be avoided in acute bacterial keratitis.
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