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A case of stromal microsporidiosis: medical strategies employed for successful resolution
  1. Anita Raghavan,
  2. Devi Rosette Raja,
  3. Narendran Venkatapathy and
  4. Ram Rammohan
  1. Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Coimbatore, Tamilnadu, India
  1. Correspondence to Dr Ram Rammohan; micro{at}


We describe the diagnosis and successful management of a case of stromal microsporidiosis, an important emerging ocular disease. Stromal microsporidiosis is recalcitrant and very often requires therapeutic keratoplasty for effective eradication. We successfully managed a steroid-treated case diagnosed only after 9 months, with a combination of polyhexamethyl biguanide 0.04%, chlorhexidine 0.04% and fluconazole 0.3% eye drops supplemented with tablet albendazole. However, complete resolution was achieved only after epithelial debridement. Toxicity due to the drugs was not noted. Diagnostic delays, steroid use and inappropriate therapy are commonly observed in stromal microsporidiosis. In spite of these potential disadvantages, our case responded well with complete eradication of the infection. The disease being fairly indolent and slowly progressive, medical therapy should be continued, in the absence of progression or other complications. Epithelial debridement may facilitate healing.

  • eye
  • infections
  • tropical medicine (infectious disease)
  • medical management
  • ophthalmology

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  • Contributors AR planning, conception, acquisition, reporting, data analysis and interpretation. DRR acquisition, reporting, data analysis and interpretation. NV reporting, data analysis and interpretation. RR planning, conception, acquisition, reporting, data analysis and interpretation.

  • 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.