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Unusual association of diseases/symptoms
Delayed diagnosis of microsporidial stromal keratitis: unusual Wessely ring presentation and partial treatment with medications against Acanthamoeba
  1. Karin E Thomas1,
  2. Tracy L Purcell1,
  3. David J Tanzer2,
  4. David J Schanzlin1
  1. 1Department of Ophthalmology, UCSD, La Jolla, California, USA
  2. 2Department of Ophthalmology, Naval Medical Center San Diego, San Diego, California, USA
  1. Correspondence to Karin E Thomas, flykarin{at}aol.com

Summary

The authors report a case of an immunocompetent 38-year-old male who presented with an indolent keratitis that eluded diagnosis after multiple cultures taken over 9 months. He was started initially on medications against Acanthamoeba, after presenting with a nearly complete corneal ring 2 months after trauma. These medications likely partially treated his condition, thereby making laboratory diagnosis more difficult. He was identified as having Encephalitozoon hellum by PCR. The patient subsequently underwent cornea transplant after a full course of medical treatment and recovered best-corrected visual acuity of 20/20.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.