Bilateral infectious keratoconjunctivitis, a way to recognize microsporidial keratitis: A case report

Abstract

Purpose:

To report a young immunocompetent patient who presented with bilateral microsporidial keratitis at Ramathibodi hospital, Thailand. 

Design: 

A case report study.

Method: 

A case presentation with bilateral keratoconjunctivitis was recorded. History taking and ophthalmic examinations were noted. The patient was sent for anterior segment photography and corneal scraping was performed to confirm the diagnosis. Subsequent treatment with topical moxifloxacin followed by combination moxifloxacin and dexamethasone phosphate eye drops were prescribed. At every follow up visit the patient was re-evaluated by slit-lamp examination and anterior segment photography.

Result:

We herein report a rare case of bilateral microsporidial keratitis in an HIV-negative young Thai male patient. He presented with keratoconjunctivitis in the right eye followed by the left eye after 4 days. Corneal scrapping with gram-chromotrope staining identified microsporidial organisms. The patient was treated successfully with topical 0.5% moxifloxacin four times a day for 3 days followed by moxifloxacin dexamethasone phosphate four times a day for 1 week. 

Conclusion:

Bilateral microsporidial keratitis is an uncommon condition often seen in immunocompromised patients. It is characterized by red eyes and blurred vision with acute or subacute presentation. Slit-lamp findings typically shows multifocal bizarre shape subepithelial corneal infiltrations. An HIV-negative patient with bilateral microsporidial keratitis is rare and early recognition and proper treatments can result in good visual recovery. 

Financial Disclosure: None