title: A case of bilateral microsporidial keratitis from Bangladesh--infection by an insect parasite from the genus Nosema.
abstract: An HIV-negative patient from Bangladesh with bilateral keratitis was found to be infected with a microsporidian parasite belonging to the genus Nosema. Significantly, the patient had bathed in a rural pond 7 days prior to the development of ocular symptoms. Nosema parasites are common insect parasites and the source of this microsporidial infection was possibly from mosquito larvae developing in the pond in which the patient bathed. The reduced temperature of the human eye and its immune status may have allowed a poikilothermic insect parasite to establish infection in the cornea of a homeothermic human host. This case highlights the opportunistic potential of insect microsporidial parasites to infect immunocompetent humans as well as those who are immunodeficient.
authors.affiliation: Electron Microscopy, Clinical Sciences Building, Manchester Royal Infirmary, Manchester M13 9WL, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Curry
authors.affiliation: National Specialist Ophthalmic Pathology Service, Department of Histopathology, E Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Mudhar
authors.affiliation: Cornea Clinic, Chittagong Eye Infirmary, PO Box 729, Pahartali, Chittagong 4000, Bangladesh.
authors.forename: Sumedh
authors.initials: S
authors.lastname: Dewan
authors.affiliation: Department of Biological Sciences, Imperial College London, Silwood Park Campus, Ascot SL4 7PY, UK.
authors.forename: Elizabeth U
authors.initials: EU
authors.lastname: Canning
authors.affiliation: Electron Microscopy Unit, Department of Histopathology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
authors.forename: Bart E
authors.initials: BE
authors.lastname: Wagner
mesh_terms: D000818:Animals; D001459:Bangladesh; D006801:Humans; D007313:Insecta / Q000382:microbiology; D007634:Keratitis / Q000382:microbiology*; D008297:Male; D016881:Microsporidiosis / Q000150:complications*; D016818:Nosema / Q000302:isolation & purification*