Six months after uncomplicated cataract surgery, a patient reports gradually blurring vision with minimal pain. Examination shows granulomatous keratic precipitates, low-grade vitritis, and a distinct whitish plaque on the posterior lens capsule. The most likely causative organism is:
- A Haemophilus influenzae
- B Candida albicans
- C Propionibacterium acnes ✓
- D Aspergillus fumigatus
Correct answer: C. Propionibacterium acnes
Explanation
Propionibacterium acnes causes delayed chronic postoperative endophthalmitis, often months later, with a characteristic sequestered white plaque within the capsular bag, mild inflammation and granulomatous features. Fungal causes such as Candida produce fluffy vitreous exudates without an intracapsular plaque, which is the discriminating finding against that distractor.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.