Characterization of Infectious Crystalline Keratitis Caused by a Human Isolate of Streptococcus mitis

Peter J McDonnell, Sergio Kwitko, Jan M. McDonnell, David Gritz, Melvin D. Trousdale

Research output: Contribution to journalArticle

Abstract

Streptococcus mitis isolated from a human with infectious crystalline keratitis was injected intrastromally into corneas of adult New Zealand white rabbits that were treated with tetracycline hydrochloride, methylprednisolone acetate, or a combination of tetracycline and methylprednisolone. Animals were followed up for up to 44 days; untreated corneas and those treated with tetracycline developed no disease or “fluffy” stromal infiltrates with overlying epithelial defects representing an abscess. Corneas treated with the combination of tetracycline and corticosteroid usually developed crystalline stromal opacities that on histopathologic examination were shown to be intrastromal aggregates of cocci. Transmission electron microscopy of crystalline lesions within 10 days of infection revealed typical cocci intermixed with a fibrillar material having periodicity characteristic of fibrinogen or fibrin, and immunoperoxidase staining for fibrinogen was positive. By 1 month, electron microscopy revealed aggregates of degenerated bacteria that were surrounded by cellular processes of activated keratocytes. Our studies demonstrate a model for crystalline keratitis in which organisms are seen to reside within the stroma for up to 44 days without an inflammatory response. Periocular corticosteroids appear to be necessary to create this model. It is possible that the organisms are isolated from the host response by fibrin or by keratocytes.

Original languageEnglish (US)
Pages (from-to)1147-1151
Number of pages5
JournalArchives of Ophthalmology
Volume109
Issue number8
DOIs
StatePublished - 1991
Externally publishedYes

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Streptococcus mitis
Keratitis
Tetracycline
Cornea
Fibrin
Fibrinogen
Adrenal Cortex Hormones
Methylprednisolone
Periodicity
Transmission Electron Microscopy
Abscess
Electron Microscopy
Staining and Labeling
Rabbits
Bacteria
Infection

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Characterization of Infectious Crystalline Keratitis Caused by a Human Isolate of Streptococcus mitis. / McDonnell, Peter J; Kwitko, Sergio; McDonnell, Jan M.; Gritz, David; Trousdale, Melvin D.

In: Archives of Ophthalmology, Vol. 109, No. 8, 1991, p. 1147-1151.

Research output: Contribution to journalArticle

McDonnell, Peter J ; Kwitko, Sergio ; McDonnell, Jan M. ; Gritz, David ; Trousdale, Melvin D. / Characterization of Infectious Crystalline Keratitis Caused by a Human Isolate of Streptococcus mitis. In: Archives of Ophthalmology. 1991 ; Vol. 109, No. 8. pp. 1147-1151.
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