Posters

Treatment of microsporidia keratoconjunctivitis with topical voriconazole in immunocompetent patients

Poster Details

First Author: Y.Altay TURKEY

Co Author(s):                        

Abstract Details

Purpose:

To  present  the two documented cases of microsporidial keratoconjunctivitis in   immunocompetent patients, that  were treated with voriconazole 1% drops and oral albendozole.

Setting:

: Ufuk University Faculty of Medicine, Ankara..

Methods:

First case was 27 years old female patient with irritation a, redness and blurred vision in the right eye of three weeks duration. Second case 40 years old male patient with foreign body sensation, blurred vision and redness of his both eyes for two weeks. On examination, both patients had punctate epitheliopathy and subepitheial infiltration diffusely throughout the cornea and conjonctival hyperemia. Follicles were present on the conjunctiva. We suspected microsporidial infection and corneal epithelial scrapings were performed in both cases.

Results:

Corneal scrapings revealed the presence of numerous oval bluish purple spores of microsporidia in Giemsa staining. Treatment was begun with oral albendazole 400 mg once daily for 14 days and topical voriconazole 1% every two hours. Voriconazole use was tapered over 4 weeks and then continued four times daily 4 weeks more.. Symtoms and signs were resolved in both patients.  But two weeks later large subepitheial nummuler lesions were seen in both patients. These lesions were completly resolved with the topical steroid drops for two weeks.Visual acuity improved to 20/20 in both cases.

Conclusions:

Microsporidia are important cause of disease in both with or without immunospression. High index of suspicion is needed for diagnosis. Definitive treatment for microsporidial keratitis has not been established. Our patients were treated effectively with topical voriconazole 1% (8 weeks) and oral albendazole (two weeks).

Financial Disclosure:

None