Abstract

INTRODUCTION:

Microsporidia are spore-forming, obligate intracellular protozoa. Humans seem to be infected only by 4 genera of microsporidia. Microsporidial keratoconjunctivitis in immunodeficient patients has a characteristic appearance.

CASE REPORT:

34 year old woman with AIDS complained of bilateral blurred vision. The visual acuity was 0.6 on both eyes. She had a mild conjunctivitis and disseminate, not very prominent intraepithelial corneal opacities. She was treated with propamidine isethionate 0.1% 5 times daily and artificial tears under presumptive diagnosis of microsporidial keratoconjunctivitis. We discontinued this treatment because of no improvement. Within 6 months the visual acuity decreased to 0.05. A conjunctival smear was positive for microsporidia. Local Fumagillin-eye-drops 0.07 mg/ml 7 times daily were given. Within 2 weeks an impressively improvement was seen. Because of an persisting diarrhea 400 mg Albendazol twice daily was added orally without success.

DISCUSSION:

The biomicroscopically changes of microsporidial keratoconjunctivitis are characteristical and lead to the clinical diagnosis. Fumagillin is in vitro and clinically a potent antimicrosporidian agent with an extremely broad therapeutic range.