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CASE REPORT
Importance of clinical signs leading to the diagnosis in a case of microbiological smear negative ocular microsporidiosis
  1. Prateek Agarwal,
  2. Ivana Romac Coc and
  3. Samuel Edward Navon
  1. Eye Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
  1. Correspondence to Dr Prateek Agarwal, dr.prateekagarwal{at}gmail.com

Abstract

A 28-year-old patient presented to us with multifocal coarse raised epithelial lesions in the left eye associated with pain watering redness and blurred vision with a visual acuity of 20/40 in the left eye. The patient had been managed elsewhere with a course of topical moxifloxacin eye-drops four times a day and topical steroids (prednisolone acetate) 1% three times a day for 2 weeks without any resolution, which was stopped 2 days ago prior to presentation at our centre. Gram stain was negative for bacteria as well as microsporidial spores. 10% KOH was negative for fungal hyphae. Based on strong clinical signs of corneal microsporidiosis, in spite of the negative microbiology smear, the patient was started on voriconazole eye-drops five times a day. The lesions started resolving in 5 days and completely healed after 17 days of therapy. No relevant history pertaining to exposure of contaminated water, swimming or history of trauma could be elicited.

  • ophthalmology
  • eye
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Footnotes

  • Patient consent for publication Obtained.

  • Contributors PA: contribution in conception and designing of manuscript. SEN: contribution in acquisition of data and analysis. IRC: contribution in interpretation and analysis and take home summary from the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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