Radial Keratoneuritis in Aeromonas Keratitis

Abstract

Purpose: We report a case of Aeromonas keratitis presenting as radial keratoneuritis. Case summary: A 33-year-old woman with a history of cleaning her contact lenses with tap water presented with decreased visual acuity for 1 day in the left eye. The patient showed diffuse corneal edema, stromal infiltration, and radial keratoneuritis, which were thought to be pathognomonic for Acanthamoeba keratitis. Based on the patient's clinical findings and past history, a diagnosis of Acanthamoeba keratitis was made and she was prescribed topical fortified cefazolin (50 mg/mL, 5%), tobramycin (3 mg/mL), and 0.02% chlorhexidine per hour. Culture results from the contact lens and contact lens solution confirmed infection by Aeromonas hydrophilia. Polymerase chain reaction results for Acanthamoeba were negative. After 8 days of treatment, the uncorrected visual acuity was 0.7/0.3 with improvement in her corneal findings. Conclusions: Radial keratoneuritis is not always pathognomic for Acanthamoeba keratitis and can be present in Aeromonas keratitis. Therefore, ophthalmologists should be cautious when interpreting this clinical sign.