Occupationally Acquired Polymicrobial Keratitis Caused by Acanthamoeba and Rare Enteric Bacteria Following Gastrointestinal Splash Exposure: A Case Report

Background Polymicrobial keratitis is an uncommon but vision‐threatening condition, particularly when it involves protozoal and bacterial pathogens. Healthcare workers may be at increased risk due to occupational exposure to hospital‐associated microorganisms. Case Presentation We report a case of severe polymicrobial keratitis in a 40‐year‐old contact lens‐wearing nurse who developed acute keratitis following inadvertent ocular exposure to nasogastric secretions while caring for a critically ill child. Contact lens culture and in vivo confocal microscopy identified Acanthamoeba , Enterococcus faecalis , Staphylococcus capitis , and Pantoea species. The patient developed progressive ring infiltrates, stromal haze, and endothelial dysfunction consistent with advanced infectious keratitis. Intensive antiamoebic and targeted antimicrobial therapy resulted in infection control but with significant corneal scarring requiring planned lamellar keratoplasty. Conclusion This case represents a rare example of occupationally acquired polymicrobial keratitis involving Acanthamoeba and multiple healthcare‐associated bacteria. It highlights the potential for gastrointestinal and hospital flora to cause severe ocular infection in contact lens users and underscores the need for heightened infection‐control awareness among healthcare workers.