Infectious crystalline keratopathy: an electron microscope analysis.
A 73-year-old man developed a crystalline stromal keratopathy in one eye following his second corneal transplant. Despite aggressive treatment with antibiotics and antifungal agents, the lesion increased in size. A corneal transplant was performed and histopathologic studies were performed using both light and transmission electron microscopy. The characteristic trilamellar structure of a bacterial cell wall was found. The organisms were present only anteriorly. Small electron-dense bodies with needle-like projections were found. These bodies may be responsible for the crystalline appearance of this keratopathy. The appearance of a crystalline keratopathy should alert clinicians to the possibility of a low-grade bacterial infection. After appropriate cultures, we advise early and aggressive therapy with appropriate antibiotics.
D000368:Aged; D001424:Bacterial Infections / Q000473:pathology*; D003315:Cornea / Q000382:microbiology / Q000648:ultrastructure; D003316:Corneal Diseases / Q000473:pathology*; D016039:Corneal Transplantation; D003460:Crystallization; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D012086:Reoperation