Uvea: chronic postoperative endophthalmitis: practice question

A Ophthalmology 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.

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Ophthalmology · Uvea: chronic postoperative endophthalmitis

Sample item

Eight weeks after uneventful cataract surgery, an eye has low-grade granulomatous inflammation with a white plaque on the posterior capsule. It improves on steroids and relapses when they are tapered. Which organism is likely?

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

The answer and the reasoning

A. Propionibacterium acnes

Delayed, low-grade endophthalmitis with a capsular plaque that relapses after steroid taper suggests Propionibacterium acnes, a slow-growing anaerobe sequestered in the capsular bag. Cure usually needs vitrectomy, capsulectomy and intravitreal antibiotics.

Option by option

  • A. Propionibacterium acnes (correct)

    Correct. A capsular plaque with steroid-responsive, relapsing inflammation is typical of this organism.

  • B. Candida albicans

    Candida albicans causes fungal infection with fluffy vitreous opacities, usually in patients with a risk factor such as a central line.

  • C. Staphylococcus epidermidis

    Staphylococcus epidermidis typically causes an acute endophthalmitis within days, not a weeks-later plaque.

  • D. Bacillus cereus

    Bacillus cereus causes a fulminant endophthalmitis within 24 hours, usually after trauma.

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.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Propionibacterium acnes. Delayed, low-grade endophthalmitis with a capsular plaque that relapses after steroid taper suggests Propionibacterium acnes, a slow-growing anaerobe sequestered in the capsular bag.

Why is "Candida albicans" not the answer?

Candida albicans causes fungal infection with fluffy vitreous opacities, usually in patients with a risk factor such as a central line.

Why is "Staphylococcus epidermidis" not the answer?

Staphylococcus epidermidis typically causes an acute endophthalmitis within days, not a weeks-later plaque.

Why is "Bacillus cereus" not the answer?

Bacillus cereus causes a fulminant endophthalmitis within 24 hours, usually after trauma.

What concept does this question test?

It tests Uvea: chronic postoperative endophthalmitis in Ophthalmology. Cure usually needs vitrectomy, capsulectomy and intravitreal antibiotics.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Uvea: chronic postoperative endophthalmitis?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology 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.