ABSTRACT
A case of endogenous Klebsiella pneumoniae endophthalmitis, cryptogenic in origin, is presented. It was treated initially with success, only to recur three months later with loss of the eye. Common sites of Klebsiella infection are reviewed. This organism rapidly destroys retinal photoreceptors. A link between Klebsiella and acute anterior uveitis has been suggested but is not supported by prospective data.
Subject(s)
Endophthalmitis/etiology , Klebsiella Infections , Sepsis/etiology , Acute Disease , Cornea/pathology , Endophthalmitis/pathology , Endophthalmitis/surgery , Eye Enucleation , Humans , Klebsiella pneumoniae/isolation & purification , Male , Middle Aged , Recurrence , Sepsis/pathology , Sepsis/surgeryABSTRACT
Comparison specular micrographs of infant and adult corneas from cats, cows, dogs, rabbits, and humans demonstrate that a large decrease in central endothelial cell density occurs during maturation of the cornea. Central endothelial cell counts of developing cat, dog, and rabbit corneas decrease rapidly during the first months of life. This rapid decline in endothelial cell density correlates with growth of the cornea to the adult size. Central endothelial cell counts of adult cat, cow, deer, dog, pig, rabbit, and human corneas are similar (2500 cells/mm2) despite a wide variation in corneal size. Comparison of observed endothelial cell counts with two hypothetical situations, one of unrestricted endothelial mitosis and the other of only endothelial hypertrophy, indicates that hypertrophy of individual cells is primarily responsible for achieving the adult cell density of 2500 cells/mm2 for these species. This observation is true for species that have a high adult endothelial mitotic capacity (rabbit) as well as those that do not (cat). The human cornea is a special case because the decline in central endothelial cell density indicates that a large apparent corneal endothelial cell loss (approximately 45%) occurs early in postnatal development.
