title: Clinical Features, Risk Factors, and Treatments of Microsporidial Epithelial Keratitis.
abstract: OBJECTIVE
  To report the clinical manifestations, risk factors, and treatments of microsporidial epithelial keratitis in Thailand.
  
  
  METHODS
  Twenty eyes of 19 patients were diagnosed and the clinical presentations, risk factors, and management were analyzed.
  
  
  RESULTS
  Of 19 patients, six patients (32%) had no apparent risk factors. Predisposing factors included soil exposure (6/19, 32%), water contamination (6/19, 32%), and eye liner (1/19, 4%). Twelve cases (63%) were detected in the rainy season. All cases presented with disseminated, punctated, elevated, epithelial keratitis. Corneal scrapings with Gram-chromotrope staining were positive in all patients. Moxifloxacin 0.5% eye drops were given and all 16 patients experienced complete resolution. Three recurrent cases were resolved with only topical moxifloxacin without corneal scraping or swabbing.
  
  
  CONCLUSIONS
  Predisposing factors were not found in some patients; thus, corneal scraping with staining should be considered in cases having a high index of suspicion. The incidence is increased during the rainy season; therefore, clinicians should have more awareness during these times. Debridement with topical moxifloxacin eye drops, without any systemic medication, may be an effective treatment. Corneal scraping or swabbing may not be required in recurrences.
authors.affiliation: a Department of Ophthalmology , Srinagarind Hospital, Khon Kaen University , Khon Kaen , Thailand .
authors.forename: Onsiri
authors.initials: O
authors.lastname: Thanathanee
authors.affiliation: a Department of Ophthalmology , Srinagarind Hospital, Khon Kaen University , Khon Kaen , Thailand .
authors.forename: Raweewan
authors.initials: R
authors.lastname: Athikulwongse
authors.affiliation: a Department of Ophthalmology , Srinagarind Hospital, Khon Kaen University , Khon Kaen , Thailand .
authors.forename: Orapin
authors.initials: O
authors.lastname: Anutarapongpan
authors.affiliation: b Department of Parasitology , Khon Kaen University , Khon Kaen , Thailand , and.|c Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University , Khon Kaen , Thailand.
authors.forename: Porntip
authors.initials: P
authors.lastname: Laummaunwai
authors.affiliation: b Department of Parasitology , Khon Kaen University , Khon Kaen , Thailand , and.|c Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University , Khon Kaen , Thailand.
authors.forename: Wanchai
authors.initials: W
authors.lastname: Maleewong
authors.affiliation: b Department of Parasitology , Khon Kaen University , Khon Kaen , Thailand , and.|c Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University , Khon Kaen , Thailand.
authors.forename: Pewpan Maleewong
authors.initials: PM
authors.lastname: Intapan
authors.affiliation: a Department of Ophthalmology , Srinagarind Hospital, Khon Kaen University , Khon Kaen , Thailand .
authors.forename: Olan
authors.initials: O
authors.lastname: Suwan-Apichon
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D003646:Debridement; D019573:Epithelium, Corneal / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D007637:Keratoconjunctivitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D008297:Male; D016816:Microsporida / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Epithelial keratitis; Gram-chromotrope stain; microsporidia; risk factors; treatment