Acanthamoeba keratitis — DTM&H MCQ

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EasyProtozoal infectionsAcanthamoeba keratitisDTM&H

A 30-year-old contact lens wearer returns from Thailand with severe eye pain, photophobia and a ring-shaped corneal infiltrate after rinsing lenses in tap water. What is the most appropriate investigation?

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Correct answer: C — Corneal scraping or confocal microscopy

Corneal scraping or confocal microscopy is the single best answer because diagnosis requires corneal sampling or specialist ocular imaging because early treatment protects vision. Blood culture is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that contact lens exposure to tap water is a key preventable risk.

Reference: Manson's Tropical Diseases; WHO neglected tropical diseases guidance; CDC DPDx