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[Infectious crystalline keratopathy: a case report].
J P Terrier1, P Calvet, E Carloz
1Service d'Anatomie et de Cytologie Pathologique, Hopital d'Instruction des Amees Sainte-Anne, 83800 Toulon, Naval, France.
Annales De Pathologie
|October 31, 2001
Summary
Perforated infectious crystalline keratopathy (ICK) is a rare condition often linked to corneal surgery and steroid use. Histologic examination is more effective than culture for diagnosing ICK by revealing bacterial clusters without inflammation.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Corneal Surgery
Background:
- Infectious crystalline keratopathy (ICK) is a rare but serious corneal infection.
- Previous corneal surgery, such as keratoplasty, and topical corticosteroid use are significant risk factors.
- The condition is characterized by distinct clinical features in the anterior corneal layers.
Observation:
- A case of perforated ICK was observed in an 88-year-old female patient.
- Clinical presentation included slowly progressive, stellate infiltrates in the anterior cornea.
- The patient had a history potentially involving corneal surgery and/or corticosteroid use.
Findings:
- Viridans streptococci are the most frequently implicated microorganisms in ICK, though difficult to culture.
- Histologic examination proved more sensitive than microbial cultures for diagnosing ICK in this case.
- Histology revealed characteristic clusters of bacteria within the corneal stroma, notably without an associated inflammatory response.
Implications:
- Accurate and timely diagnosis of ICK is crucial to prevent severe complications like perforation.
- Histopathologic examination should be considered a highly sensitive diagnostic tool for ICK, especially when cultures are negative or difficult.
- Understanding the pathogenesis, including the host's lack of inflammatory response to bacteria in ICK, is important for effective management.