Abstract
Microbial, infectious keratitis is a relevant indication for penetrating keratoplasty.
The requirement for transplantation results in histopathological examination of the
entire thickness
of the cornea. Although the clinical diagnosis is not always possible to confirm,
pathology can support diagnostic evidence of clinical presentation and pathogenesis.
This is achieved with
multiple methods from cytology, histochemistry, immunohistology, molecular pathology
and in rare cases electron microscopy. These allow tissue-based detection of previous
and parallel
diseases and the responsible pathogens. The failure of satisfactory clinicopathological
correlation raises the question whether a suspected pathogen was not ultimately responsible
for
destroyed corneal tissue. The pathogenesis of keratitis requiring transplantation
is not yet completely understood, also on the experimental level. The development
of such a keratitis can
lead to a clinical symptomatology which can be described as “threatening organ
dysfunction”, a term used in sepsis research. Considering recent literature, possible
correlations between
sepsis and microbial keratitis and their relation to histopathology are discussed.
Key words
pathology - cornea - sepsis - infectiology - keratitis - keratoplasty
