title: Is microsporidial keratitis an emerging cause of stromal keratitis? A case series study.
abstract: BACKGROUND
  Microsporidial keratitis is a rare cause of stromal keratitis. We present a series of five cases of microsporidial keratitis from a single centre in southern India with microbiologic and histopathologic features.
  
  
  METHODS
  Patient charts of five cases of microsporidial stromal keratitis diagnosed between January 2002 and June 2004 were reviewed retrospectively for clinical data, microbiologic and histopathologic data. The presence of microsporidia was confirmed by special stains on corneal scrapings and/or corneal tissues, and electron microscopy. All patients were immunocompetent with a preceding history of trauma in three. Four patients presented with unilateral, small, persisting deep stromal infiltrates, of uncertain etiology, in the cornea, which were not responding to conventional antimicrobial treatment and required penetrating keratoplasty in three. Fifth case was unsuspected and underwent keratoplasty for post-traumatic scar. Three of five cases were diagnosed on corneal scrapings, prior to keratoplasty, while two were diagnosed only on histology. The microsporidia appeared as oval well defined bodies with dense staining at one pole. None of the patients showed recurrence following keratoplasty.
  
  
  CONCLUSIONS
  Microsporidia, though rare, should be suspected in chronic culture-negative stromal keratitis. Organisms could lie dormant without associated inflammation.
authors.affiliation: Ophthalmic Pathology Service, L.V. Prasad Eye Institute, Hyderabad, India. geeta@lvpei.org
authors.forename: Geeta K
authors.initials: GK
authors.lastname: Vemuganti
authors.forename: Prashant
authors.initials: P
authors.lastname: Garg
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.forename: Joveeta
authors.initials: J
authors.lastname: Joseph
authors.forename: Usha
authors.initials: U
authors.lastname: Gopinathan
authors.forename: Shashi
authors.initials: S
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003319:Corneal Stroma / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D016814:Microsporidia / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents