Characteristics of microsporidial keratoconjunctivitis in an eastern indian cohort: A case series

Sengupta, Jayangshu; Saha, Suman; Khetan, Archana; Pal, Dipanjan; Gangopadhyay, Nibaran; Banerjee, Debdulal

doi:10.4103/0377-4929.85094

Cited by 13 publications

(6 citation statements)

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“…Throughout the 1990s, multiple cases of microsporidial keratoconjunctivitis (MKC) were diagnosed in individuals with immunosuppression secondary to acquired immunodeficiency syndrome (AIDS) [37][38][39]. Since then, numerous reports of MKC in healthy, immunocompetent adults have arisen over the past 2 decades [21,40,41]. The worldwide prevalence of MKC is on the rise due to increased awareness; nonetheless, most cases go undiagnosed or misdiagnosed as atypical adenoviral keratoconjunctivitis [42].…”

Section: Microsporidial Keratoconjunctivitismentioning

confidence: 99%

A Narrative Review of Microsporidial Infections of the Cornea

et al. 2020

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Microsporidia are a rare and commonly misdiagnosed cause of corneal infection, accounting for approximately 0.4% of cases of microbial keratitis in some populations. Ocular microsporidiosis most often presents as either microsporidial keratoconjunctivitis (MKC) or microsporidial stromal keratitis (MSK). Though these two clinical entities exhibit similar symptomology, they are distinguished from one another by the time course for disease progression, findings on slit-lamp examination, and response to medical therapy. This review summarizes the current literature on the etiology and clinical presentation of microsporidial infections of the cornea and highlights ongoing developments in available diagnostic modalities and treatment regimens.

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Section: Microsporidial Keratoconjunctivitismentioning

confidence: 99%

A Narrative Review of Microsporidial Infections of the Cornea

et al. 2020

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“…Though initially it was believed to be a pathogen of the immunocompromised it has now been reported in a number of immunocompetent cases in various countries [8,9]. Increasing number of cases microsporidial keratoconjunctivitis has been reported mostly in Singapore [8,10,11] and India [12], among healthy, immunocompetent persons since the early 2000s.…”

Section: Problem Statementmentioning

confidence: 99%

“…Drinking water, can act as a reservoir for microsporidia since chlorination does not inactivate spores. Recent studies indicate a high prevalence of microsporidial keratoconjunctivitis in the rainy season, especially in India [12]. Other risk factors are trauma, dust particles, contact lens, insect bites, bathing in unclean river waters and LASIK surgery [16][17][18].…”

Section: Risk Factorsmentioning

confidence: 99%

Microsporidial Keratitis

Bhosale¹,

Ganesan²

2015

J Bacteriol Parasitol

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Hundreds of genera and thousands of species of obligate intracellular spore forming eukaryotes constitute the phylum Microspora. Currently these organisms are known to cause infections in the immunocompromised individuals in whom they exhibit diverse clinical manifestations including pulmonary, ocular, intestinal, muscular and renal disease. Ocular microsporidiosis can present as an isolated entity or as a part of systemic infection. Infection is acquired by traumatic inoculation or by contact with contaminated soil or water. Clinically this infection can present as stromal keratitis, scleritis, keratoconjuntivitis and endophthalmitis. Seven genera have been found to be associated with human ocular infections. Infections by these pathogenic organisms involve unique pathogenic mechanism-injection of the sporoplasm in the host cell via polar tube. Protean clinical manifestations and resemblance to herpetic keratitis poses as a challenge in clinical diagnosis of this condition. Diagnosis therefore mainly depends on morphological demonstration of these organisms. Electron microscopy is the 'gold standard' diagnostic method to detect microsporidial spores. Molecular methods like PCR, real time PCR are sensitive tests and aids in identification till the species level. Drugs like albendazole and fumagillin are widely used to treat microsporidial keratitis. Penetrating keratoplasty is useful in treating medically non responding cases.

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“…Encephalitozoon (Septata) intestinalis has been associated with diarrhea, disseminated infection, and superficial keratoconjunctivitis (Cali et al, 1993;Visvesvara et al, 1995;Sheikh et al, 2000). Nosema, Vittaforma, and Microsporidium have been associated with stromal keratitis in immunocompetent hosts (Shadduck et al, 1990;Rastrelli et al, 1994;Sengupta et al, 2011). Pleistophora, Anncaliia, Tubulinosema, and Trachipleistophora have been associated with myositis (Chupp et al, 1993;Cali et al, 1996;Field et al, 1996;Cali & Takvorian, 2003;Choudhary et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

T cell response and persistence of the microsporidia

Ghosh

Weiss

2012

FEMS Microbiol Rev

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The microsporidia are a diverse phylum of obligate intracellular parasites related to the fungi that cause significant and sometimes life-threatening disease in immune-compromised hosts, such as AIDS and organ transplant patients. More recently, their role in causing pathology in immune-competent populations has also been appreciated. Interestingly, in several instances, the microsporidia have been shown to persist in their hosts long term, causing at opposite ends of the spectrum either an intractable chronic diarrhea and wasting in patients with advanced-stage AIDS or asymptomatic shedding of spores in healthy populations. Much remains to be studied regarding the immune response to these pathogens, but it seems clear that CD8+ T cells are essential in clearing infection. However, in the infection models examined thus far, the role for CD4+ T cells is unclear at best. Here, we discuss the possible reasons and ramifications of what may be a weak primary CD4+ T cell response against Encephalitozoon cuniculi. Given the central role of the CD4+ T cell in other models of adaptive immunity, a better appreciation of its role in responding to microsporidia may provide insight into the survival strategies of these pathogens, which allow them to persist in hosts of varied immune status.

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Characteristics of microsporidial keratoconjunctivitis in an eastern indian cohort: A case series

Abstract: MKC can occur in normal patients with exposure to rain and mud, related to outdoor activity often misdiagnosed as viral ocular infections. Strong clinical suspicion with proper microbiological evaluation helps to diagnose this commonly misdiagnosed condition.

Cited by 13 publications

References 0 publications

A Narrative Review of Microsporidial Infections of the Cornea

A Narrative Review of Microsporidial Infections of the Cornea

Microsporidial Keratitis

T cell response and persistence of the microsporidia

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