Open AccessMicrosporidial stromal keratitis: an uncommon etiology of bilateral simultaneous corneal infection
Author(s) -
Pragnya Rao Donthineni,
Somasheila I Murthy,
Joveeta Joseph,
Prashant Garg,
Manisha Acharya,
Virender S Sangwan
Publication year - 2020
Publication title -
asian journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 5
eISSN - 2452-0691
pISSN - 1560-2133
DOI - 10.35119/asjoo.v17i3.720
Subject(s) - medicine , keratitis , corneal transplantation , etiology , fungal keratitis , stromal cell , histopathology , corneal transplant , surgery , transplantation , ophthalmology , pathology
We report three cases of bilateral microsporidial keratitis, which is an unusual presentation. All three patients presented with bilateral, simultaneous, asymmetrical, deep stromal corneal infiltrates with symptoms ranging from 5 to 12 months. Predisposing factors were noted in two of three patients. Corneal scrapings for microbiology and histopathology of corneal tissue revealed microsporidial spores from both eyes of all patients. There was no response to medical therapy and all underwent bilateral corneal transplantation. Case one additionally had recurrences in the graft and underwent repeat keratoplasties and eventually keratoprosthesis. Microsporidial stromal keratitis is a possible cause of keratitis in cases of very long-standing, indolent, culture-negative, deep stromal corneal infiltrates. So far, this infection has been reported as unilateral; however, we report these cases of bilateral infection, which is rare. Corneal transplantation is the preferred line of management due to lack of response to medical therapy.