Related Experiment Video
Updated: Aug 8, 2026
Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing
Published on: July 10, 2018
Propionibacterium acnes as a cause of visually significant corneal ulcers
J P Underdahl1, G J Florakis, R E Braunstein
1Jules Stein Eye Institute, UCLA, Los Angeles, California 90095, USA.
Purpose:
To report Propionibacterium acnes as a cause of vision-threatening infectious keratitis and to discuss culture isolation and antibiotic treatment.
Methods:
Retrospective case series presentation collected from three academic medical centers.
Results:
Six cases of P. acnes infectious keratitis are presented, all of which were associated with a compromised corneal barrier or environment. All cases were culture-positive on thioglycolate broth; none became positive before 7 days of growth. No other organisms were isolated from any culture, and the growth of P. acnes occurred in some cases despite negative gram stains.
Conclusion:
P. acnes can produce vision-debilitating keratitis when the cornea is compromised. Growth in culture should be monitored for at least 10 days to ensure isolation of this fastidious organism. P. acnes may respond to several different antibiotics that have gram-positive coverage, but it should be treated with vancomycin to enhance clearance of the organism.
Insights
Propionibacterium acnes (P. acnes) can cause severe infectious keratitis, especially with a compromised cornea. Early diagnosis requires prolonged culture monitoring, and vancomycin is recommended for effective treatment.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Propionibacterium acnes (P. acnes) is a common skin commensal.
- Infectious keratitis can lead to significant vision loss.
Observation:
- P. acnes was identified as the causative agent in six cases of vision-threatening infectious keratitis.
- All cases involved a compromised corneal barrier or environment.
Findings:
- P. acnes keratitis requires extended culture incubation (≥10 days) for isolation, often despite negative Gram stains.
- Thioglycolate broth cultures were positive in all cases, with no other organisms detected.
Implications:
- P. acnes should be considered in the differential diagnosis of infectious keratitis, particularly in eyes with predisposing factors.
- Prompt and appropriate antibiotic therapy, including vancomycin, is crucial for managing P. acnes keratitis.
- Awareness of P. acnes's fastidious growth characteristics is essential for laboratory diagnosis.
More Related Videos
Related Concept Videos
01:24Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
01:30Peptic Ulcer Disease I: Introduction
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:27The Skin Microbiota
01:22Microbiome of the Eye
01:27Acne Infection
01:24Peptic Ulcer Disease II: Pathophysiology