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Occupationally Acquired Polymicrobial Keratitis Caused by Acanthamoeba and Rare Enteric Bacteria Following

Fatma Elnaggar1,2, Heba AlSharif1, Muhammad Haris Mazhar3

  • 1Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, kkesh.med.sa.

Case Reports in Infectious Diseases
|June 10, 2026
PubMed
Abstract

Insights

Healthcare workers are at risk for severe polymicrobial keratitis from occupational exposure. A nurse developed vision-threatening keratitis due to Acanthamoeba and bacteria from patient secretions, highlighting infection control needs.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Polymicrobial keratitis, especially with protozoal and bacterial pathogens, is a rare but serious vision-threatening condition.
  • Healthcare workers face increased risk due to occupational exposure to hospital-associated microorganisms.

Purpose of the Study:

  • To report a rare case of occupationally acquired severe polymicrobial keratitis.
  • To highlight the role of healthcare-associated microorganisms in ocular infections among contact lens users.

Main Methods:

  • Case report of a nurse with severe keratitis after ocular exposure to nasogastric secretions.
  • Identification of pathogens using contact lens culture and in vivo confocal microscopy.
  • Clinical assessment of corneal changes and treatment response.

Main Results:

  • The patient presented with severe polymicrobial keratitis caused by Acanthamoeba, Enterococcus faecalis, Staphylococcus capitis, and Pantoea species.
  • Progressive ring infiltrates, stromal haze, and endothelial dysfunction were observed.
  • Intensive therapy controlled the infection but resulted in corneal scarring requiring keratoplasty.

Conclusions:

  • This case illustrates a rare instance of occupationally acquired polymicrobial keratitis involving Acanthamoeba and healthcare-associated bacteria.
  • It emphasizes the risk of severe ocular infections in contact lens users from gastrointestinal and hospital flora.
  • Heightened infection-control awareness among healthcare workers is crucial.
Keywords:
acanthamoebacase reportcontact lensesoccupational exposurepolymicrobial keratitis

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