Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences , New Delhi , India and.
Ocul Immunol Inflamm. 2013 Dec;21(6):495-7. doi: 10.3109/09273948.2013.824105. Epub 2013 Aug 26.
To report a case of infectious keratitis due to Microsporidium after collagen crosslinking (CXL).
A 36-year-old man presented with a 3-day history of pain, redness and diminution of vision in his left eye. The patient had received CXL for keratoconus in the left eye 6 days prior to presentation. Best-corrected visual acuity (BCVA) was 20/25 OD and counting fingers OS. Slit lamp examination of the left eye showed a central epithelial defect measuring and multiple stromal infiltrates.
Gram and Giemsa staining of corneal scrapings showed spores characteristic of Microsporidia. Hourly 0.5% moxifloxacin eye drops, 0.5% moxifloxcain eye ointment nocte and oral albendazole 400 mg twice daily were commenced. Corneal debridement was performed twice during the first week. At the end of 6 weeks BCVA was 20/60 in the left eye.
Microsporidial infection can be confirmed on microbiological examination. Our case responded well to medical treatment alone.
报告一例胶原交联（CXL）后感染性角膜炎与微孢子虫有关的病例。
一名 36 岁男性因左眼疼痛、发红和视力下降 3 天就诊。该患者在就诊前 6 天左眼行 CXL 治疗圆锥角膜。最佳矫正视力（BCVA）为 OD 20/25，OS 数指。左眼裂隙灯检查显示中央上皮缺损，直径测量值为[X]mm，伴有多处基质浸润。
角膜刮片革兰氏和吉姆萨染色显示具有微孢子虫特征的孢子。开始每小时滴 0.5%莫西沙星滴眼液，每晚滴 0.5%莫西沙星眼膏，每日口服两次 400mg 阿苯达唑。在第一周内进行了两次角膜清创术。6 周后左眼 BCVA 为 20/60。
可以通过微生物检查确认微孢子虫感染。我们的病例仅通过药物治疗反应良好。
