Mycology: fungal keratitis: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Microbiology · Mycology: fungal keratitis

Sample item

A farmer scratched his eye with a sugarcane leaf. He has a corneal ulcer with feathery margins and satellite lesions, and a KOH mount of the scraping shows septate branching hyaline hyphae. Which initial topical therapy is most appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Natamycin 5% suspension

Trauma with vegetable matter and feathery ulcer margins with satellite lesions suggest filamentous fungal keratitis, commonly from Fusarium or Aspergillus. Topical natamycin is first-line, and in a randomised trial it gave better outcomes than voriconazole, particularly for Fusarium. Corticosteroids worsen fungal infections.

Option by option

  • A. Moxifloxacin 0.5% eye drops

    Moxifloxacin treats bacterial keratitis and has no antifungal activity.

  • B. Natamycin 5% suspension (correct)

    Correct. Natamycin is the standard initial topical agent for filamentous fungal keratitis.

  • C. Acyclovir 3% eye ointment

    Acyclovir treats herpes simplex keratitis with dendritic ulcers.

  • D. Betamethasone eye drops

    Topical steroids can accelerate fungal growth and perforation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Natamycin 5% suspension. Trauma with vegetable matter and feathery ulcer margins with satellite lesions suggest filamentous fungal keratitis, commonly from Fusarium or Aspergillus.

Why is "Moxifloxacin 0.5% eye drops" not the answer?

Moxifloxacin treats bacterial keratitis and has no antifungal activity.

Why is "Acyclovir 3% eye ointment" not the answer?

Acyclovir treats herpes simplex keratitis with dendritic ulcers.

Why is "Betamethasone eye drops" not the answer?

Topical steroids can accelerate fungal growth and perforation.

What concept does this question test?

It tests Mycology: fungal keratitis in Microbiology. Topical natamycin is first-line, and in a randomised trial it gave better outcomes than voriconazole, particularly for Fusarium. Corticosteroids worsen fungal infections.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mycology: fungal keratitis?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.