title: Microsporidial stromal keratitis successfully treated with medical therapy: a case report.
abstract: OBJECTIVE
  To report a case of stromal microsporidiosis that responded to medical treatment with systemic albendazole and topical chlorhexidine.
  
  
  METHODS
  A 14-year-old adolescent girl presented with a 3-month history of recurrent redness, pain, and dense anterior stromal corneal infiltrate. Repeated microbiological evaluation helped identify microsporidia from the fifth scraping. Initial therapy with fluoroquinolones failed; 0.02% topical chlorhexidine gluconate hourly and 400 mg of oral albendazole twice daily and later 0.5% loteprednol etabonate were given for a total of 12 weeks.
  
  
  RESULTS
  There was complete resolution of the infection with corneal scarring with no episodes of recurrence at 1 year of follow-up. The final best-corrected visual acuity was 20/30.
  
  
  CONCLUSIONS
  The diagnosis of microsporidia can be challenging, and corneal scraping should be repeated several times in cases having a high index of suspicion. Medical therapy can prove successful in selected cases where the infection may be limited to midstroma.
authors.affiliation: Cornea and Anterior Segment Services, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Vishram A
authors.initials: VA
authors.lastname: Sangit
authors.forename: Somasheila I
authors.initials: SI
authors.lastname: Murthy
authors.forename: Prashant
authors.initials: P
authors.lastname: Garg
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D015766:Albendazole / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003319:Corneal Stroma / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D021861:Microsporidia, Unclassified / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D015766:Albendazole; C010882:chlorhexidine gluconate; D002710:Chlorhexidine