Microsporidial keratitis after collagen cross-linking

Ocul Immunol Inflamm. 2013 Dec;21(6):495-7. doi: 10.3109/09273948.2013.824105. Epub 2013 Aug 26.

Abstract

Purpose: To report a case of infectious keratitis due to Microsporidium after collagen crosslinking (CXL).

Methods: A 36-year-old man presented with a 3-day history of pain, redness and diminution of vision in his left eye. The patient had received CXL for keratoconus in the left eye 6 days prior to presentation. Best-corrected visual acuity (BCVA) was 20/25 OD and counting fingers OS. Slit lamp examination of the left eye showed a central epithelial defect measuring and multiple stromal infiltrates.

Results: Gram and Giemsa staining of corneal scrapings showed spores characteristic of Microsporidia. Hourly 0.5% moxifloxacin eye drops, 0.5% moxifloxcain eye ointment nocte and oral albendazole 400 mg twice daily were commenced. Corneal debridement was performed twice during the first week. At the end of 6 weeks BCVA was 20/60 in the left eye.

Conclusions: Microsporidial infection can be confirmed on microbiological examination. Our case responded well to medical treatment alone.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Collagen / administration & dosage
  • Collagen / adverse effects*
  • Cornea / microbiology
  • Cornea / pathology
  • Cross-Linking Reagents / administration & dosage
  • Cross-Linking Reagents / adverse effects*
  • Diagnosis, Differential
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / microbiology*
  • Humans
  • Injections
  • Keratitis / diagnosis
  • Keratitis / microbiology*
  • Keratoconus / surgery
  • Male
  • Microsporidia / isolation & purification*
  • Microsporidiosis / diagnosis
  • Microsporidiosis / microbiology*
  • Prosthesis Implantation / adverse effects
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / microbiology*
  • Visual Acuity

Substances

  • Cross-Linking Reagents
  • Collagen