Successful treatment of microsporidial keratoconjunctivitis with topical fumagillin in a patient with AIDS.
There recently have been several reports of microsporidial keratoconjunctivitis caused by the organism Encephalitozoon hellem. However, treatment of this infection has been largely ineffective. We report a case of a 35-year-old Hispanic woman with AIDS and E. hellem keratoconjunctivitis confirmed with light, electron, and immunofluorescence microscopy that resolved promptly with topical fumagillin, a crystalline antibiotic with proven efficacy against Encephalitozoon species. No corneal or systemic toxicities were noted using the dosage and preparation employed (10 mg/ml suspension in balanced salt solution). An easily prepared, topical fumagillin suspension appears to be a safe, effective treatment for E. hellem keratoconjunctivitis.
Rosberger
D F
DF
Department of Ophthalmology, New York Hospital, Cornell University Medical College, New York.
Serdarevic
O N
ON
Erlandson
R A
RA
Bryan
R T
RT
Schwartz
D A
DA
Visvesvara
G S
GS
Keenan
P C
PC
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D003510:Cyclohexanes; D016819:Encephalitozoon; D016890:Encephalitozoonosis / Q000188:drug therapy*; D015822:Eye Infections, Parasitic / Q000188:drug therapy*; D005231:Fatty Acids, Unsaturated / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007637:Keratoconjunctivitis / Q000188:drug therapy* / Q000469:parasitology; D009883:Ophthalmic Solutions; D012717:Sesquiterpenes
D000981:Antiprotozoal Agents; D003510:Cyclohexanes; D005231:Fatty Acids, Unsaturated; D009883:Ophthalmic Solutions; D012717:Sesquiterpenes; C026211:fumagillin