Infectious crystalline keratopathy caused by Streptococcus Abiotrophia defectiva.
OBJECTIVE
To report the first case of Streptococcus Abiotrophia defectiva-associated crystalline keratopathy.


METHODS
An 83-year-old woman underwent penetrating keratoplasty for pseudophakic bullous keratopathy in the OD. Ten months after surgery, the patient presented with decreased visual acuity in the OD. Slit-lamp examination showed crystalline keratopathy. Corneal scrapings were negative, and the patient was treated empirically with 2 fortified antibiotics (ciprofloxacin and vancomycin). Despite these treatments, the surface of the infiltrate increased and corneal regrafting was performed 6 weeks later. The excised prior graft was evaluated microbiologically [culture and polymerase chain reaction (PCR)] and histopathologically.


RESULTS
In the explanted corneal graft, cultures grew Streptococcus A. defectiva, and its DNA was demonstrated by broad-range PCR (16S ribosomal DNA).


CONCLUSIONS
A. defectiva can be a causative organism of infectious crystalline keratopathy. Risk factors may include long-term corticosteroid use and prior corneal transplantation. The present case confirms that PCR can be a useful technique in the diagnosis of deep infectious keratitis.
Department of Ophthalmology, University Hospital of Strasbourg, Strasbourg, France. florence.abry@chru-strasbourg.fr
Florence
F
Abry
Arnaud
A
Sauer
Philippe
P
Riegel
Maher
M
Saleh
David
D
Gaucher
Claude
C
Speeg-Schatz
Tristan
T
Bourcier
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D004269:DNA, Bacterial / Q000032:analysis; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012086:Reoperation; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D013291:Streptococcus / Q000235:genetics / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S