Acanthamoeba and Stenotrophomonas maltophilia keratitis with fungal keratitis in the contralateral eye

PURPOSE: The purpose of this study is to describe the diagnosis, course, and outcome of a case of Acanthamoeba and Stenotrophomonas keratitis with a fungal keratitis in the contralateral eye. METHODS: A case of Acanthamoeba and Stenotrophomonas keratitis was diagnosed with confocal microscopy and cultures with confocal diagnosis of fungal keratitis in the fellow eye. RESULTS: During the initial treatment of the Acanthamoeba and Stenotrophomonas keratitis, the contralateral eye developed a keratitis that demonstrated hyphae in the corneal stroma with confocal microscopy consistent with fungal keratitis. CONCLUSIONS: Bilateral chronic keratitis cannot be assumed to be caused by the same organism and independent cultures, and confocal microscopy needs to be performed to direct appropriate therapy.