A 69-Year-Old Male with Chronic Keratitis

(See page 2545 in this issue [doi:10.1128/JCM.00542-12] for photo quiz case presentation) Keratitis (infection of the corneal epithelium) is a relativelycommon eye disease. Viruses, including herpesvirus, varicel-la-zoster virus, and adenovirus, as well as intracellular bacteria of the genus Chlamydia, may infect the eye epithelium. Bacteria and fungi may invade the stroma and cause a suppurative keratitis. Unresolved or worsening keratitis cases may be referred to an ophthalmologist or cornea specialist, but in some cases, the eye may be permanently damaged before the patient is seen by a spe-cialist. Corneal scrapings, collected with a platinum Kimura spat-ula, are the preferred specimen. If the patient undergoes eye sur-gery, corneal biopsy specimens may be submitted, as in this case. Patient history may be a valuable tool in evaluating unresolved keratitis. A history of contact lens use and a corneal ring infiltrate in conjunction with extreme pain strongly hint at amoebic kera-titis, and thus, an amoeba culture should be ordered in conjunc