Infectious crystalline keratopathy caused by gram-negative bacteria.
OBJECTIVE
To identify the characteristics and outcomes of infectious crystalline keratopathy caused by gram-negative bacteria.


METHODS
We reviewed all patients treated at a university eye center for infectious crystalline keratopathy from 1978 through 1995 and performed a nested case-comparison study by comparing patients with keratitis caused by gram-negative rods and those with keratitis caused by gram-positive cocci.


RESULTS
Eighteen patients (mean age +/- SD, 59 +/- 17 years) displayed unilateral culture-positive infectious crystalline keratopathy. Among 18 eyes with crystalline keratopathy, five occurrences (28%) were caused by gram-negative rods (Acinetobacter lwoffi, Citrobacter koseri, Enterobacter aerogenes, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia), 10 (55%) were caused primarily by gram-positive cocci, and three (17%) were caused primarily by yeasts. Four cases grew two different isolates. No significant difference in predisposing factors, clinical appearance, or visual outcome was found between infections caused by gram-negative bacteria and those caused by gram-positive bacteria.


CONCLUSIONS
Gram-negative bacteria can cause infectious crystalline keratopathy but have no distinguishing features from infectious crystalline keratopathy caused by streptococci and other gram-positive bacteria. Appropriate laboratory evaluation is therefore necessary to guide specific antimicrobial therapy.
Khater
T T
TT
Cullen Eye Institute, Houston, TX 77030, USA. tkhater@bcm.tmc.edu
Jones
D B
DB
Wilhelmus
K R
KR
D000368:Aged; D003315:Cornea / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D016039:Corneal Transplantation; D015818:Eye Infections, Bacterial / Q000209:etiology / Q000473:pathology / Q000628:therapy; D015821:Eye Infections, Fungal / Q000209:etiology / Q000473:pathology / Q000628:therapy; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity
D005938:Glucocorticoids; D009883:Ophthalmic Solutions