Antibiotic resistance of crystalline bacterial ingrowth in a corneal graft.
Four recent reports have described the clinical appearance of fine needle-like opacities in the corneal stroma of six patients. In five of these patients these developed in a corneal graft. Histologically, all the corneal buttons had bacterial ingrowth between the stromal lamellae, with a striking lack of inflammatory response. We report a patient in whom this process occurred following penetrating keratoplasty. Intensive topical antibiotic treatment failed, and she underwent a second, successful, penetrating keratoplasty. Postoperatively, this patient has maintained good vision with no recurrence for over three years. Histologic and ultrastructural study of the corneal button revealed viable and nonviable gram-positive cocci with a marked paucity of inflammatory infiltrate.
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D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D003316:Corneal Diseases / Q000188:drug therapy / Q000209:etiology*; D016039:Corneal Transplantation; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans
D000900:Anti-Bacterial Agents