Abstract
Abstract: :
Purpose: To document the correlation between microbiology culture and histopathology in the detection of bacterial and fungal pathogens in post-enucleated or post-eviscerated corneal tissue. Methods: The microbiology and pathology records of all patients treated for bacterial or fungal keratitis at The Bascom Palmer Eye Institute between January 1, 1996, and December 31, 2000, were reviewed. Twenty-six cases were identified that underwent enucleation or evisceration with both microbiology and pathology records. Results: Overall, microbiology culture was positive in 18 cases (69%) and pathology was positive in 5 cases (19%). There were no findings in 7 cases (27%). The microbiology and pathology findings matched in 11 cases, giving an efficiency of 42%. Of the 15 cases (58%) with discordant results, microbiology was positive in 14 cases (54%) and pathology was positive in 1 case (46%). Using the culture results as the gold standard, pathology findings were 22% sensitive and 33% specific. Pathology results had a positive predictive value of 80% and a negative predictive value of 64%. Using the pathology findings as the gold standard, microbiology results were 36% sensitive and 88% specific. Microbiology findings had a positive predictive value of 22% and a negative predictive value of 64%. Fungus was identified as the infectious etiology in 4 cases (15%). Of the fungal cases, 2 cases (50%) had microbiology findings and 2 cases (50%) had pathology findings. Bacteria was identified as the causative organism in 15 cases (58%). Of the bacterial cases, 15 cases (100%) had microbiology findings and 3 cases (20%) had pathology findings. Conclusions: Microbiology and histopathology are complementary in identifying the etiology in corneal tissue following enucleation or evisceration. Overall, microbiology is more sensitive than pathology. The two modalities are equal in detecting fungus. Microbiology is more sensitive in detecting bacterial organisms than pathology evaluation.