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. 2016 Dec;6(1):30.
doi: 10.1186/s12348-016-0099-7. Epub 2016 Sep 1.

Microsporidial stromal keratitis and endophthalmitis in an immunocompetent patient

Arjun B Sood  1   2 , Matthew R Debiec  3 , Steven Yeh  4   5 , Hans E Grossniklaus  4   5 , J Bradley Randleman  6   7
Affiliations

Microsporidial stromal keratitis and endophthalmitis in an immunocompetent patient

Arjun B Sood et al. J Ophthalmic Inflamm Infect. 2016 Dec.

Abstract

Purpose: The purpose of this study is to report a case of microsporidial endophthalmitis after penetrating keratoplasty in a healthy patient and discuss the management.

Methods: This is a case report.

Results: A 69-year-old healthy male underwent penetrating keratoplasty for corneal scar secondary to herpes stromal keratitis. He presented with features of acute graft rejection 3 years later. After failure of medical management, a repeat full thickness keratoplasty was performed. Pathologic examination of the corneal specimen showed microsporidia. The patient then developed a chronic endophthalmitis, and a vitreous tap and injection followed by pars plana vitrectomy were performed. Pathologic examination of tissue showed microsporidia.

Conclusions: Microsporidia are being increasingly identified as the cause of stromal keratitis. This is the first report of microsporidial endophthalmitis in a patient without underlying systemic illness.

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Figures

Fig. 1
Fig. 1
External photograph of left eye. The corneal sutures are intact. There is a yellow opacity overlying the pupil
Fig. 2
Fig. 2
The superficial stroma showing organisms measuring 2 μm × 4 μm
Fig. 3
Fig. 3
Intrastromal organisms without polarization (left) and with polarization (middle) and staining with AFB (right)
Fig. 4
Fig. 4
Transmission electron microscopy showing a 2 μm × 4 μm organism that contains an anchoring disk exospore, endospore, polaroplast, polar filament coils, nucleus, and ribosomes
See this image and copyright information in PMC

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