Use of Different Stains for Microscopic Evaluation of Corneal Scrapings for Diagnosis of Microsporidial Keratitis

Joseph, Joveeta; Murthy, Somasheila I; Garg, Prashant; Sharma, Savitri

doi:10.1128/jcm.44.2.583-585.2006

Cited by 50 publications

(33 citation statements)

References 12 publications

(12 reference statements)

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“…Various stains may be applied to fixed corneal scrapings, although a potassium hydroxide-calcofluor white stain was found to be most efficient in one study (303). A PCR assay has also been developed for the detection of V. corneae DNA in corneal scrapings (468).…”

Section: Nonenteric Microsporidiamentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

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Section: Nonenteric Microsporidiamentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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“…In past reports, microsporidial keratitis usually was found to occur as epithelial keratitis in patients with AIDS (1,11,(22)(23)(24)37) and as stromal disease in immunocompetent individuals (34)(35). Recently, it has been found to manifest as keratoconjunctivitis with involvement of the corneal epithelium mainly in healthy individuals (4,13,21,30,32), and it is considered an emerging ocular disease (21). To date, a number of studies were reported on the predisposing factors for microsporidial keratitis in immunocompetent individuals (2,14,15,19,21,32).…”

mentioning

confidence: 99%

“…It is usually not difficult to make the diagnosis based on the characteristic presentations. The infection can be confirmed by detecting microsporidia in the scraped corneal tissues with various staining techniques (6,13,15,21). To date, a sensitive PCR technique has been developed for the diagnosis (14).…”

mentioning

confidence: 99%

Microsporidial Keratitis in Patients with Hot Springs Exposure

Fan

Chen

et al. 2012

J Clin Microbiol

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This retrospective study included 10 eyes of 9 patients diagnosed with microsporidial keratitis. All of them were known to contract this disease after taking baths in hot springs. The disease was diagnosed based on detecting microsporidia in corneal scrapings using Gram stain and the modified Kinyoun's acid-fast stain. The specimens from the last six patients were subjected to PCR and then sequencing. All of them revealed that the microorganism identified has a high similarity to Vittaforma corneae. Repeated debridement of the epithelial lesions successfully eradicated the microsporidial infection in all nine patients.

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“…As with all parasitology microscopy, the presence and use of a calibrated micrometer eyepiece is essential so that sizes can be measured accurately. The spores of microsporidia have been reported to stain grampositive 5 or gram-variable to gram-positive 6 ; however, given that those found in human intestinal infections are typically bacterial in size (ie, in the range of 0.7 to 1 µm wide and 1.4 to 3 µm long), it is impossible to identify these as microsporidia by size and morphology as seen in standard gram-stained smears of feces. 7 …”

Section: Gram Stainmentioning

confidence: 97%

“…In a study comparing different stains for the diagnosis of microsporidial keratitis, however, it was found that in 28 of 30 cases of microsporidial keratitis, acid-fast microsporidial spores were seen using a modified Ziehl-Neelsen stain with 1% H 2 SO 4 as the decolorizer. 5 No microsporidium genus/species identifications were made in either report, but it is known that different genera are typically responsible for intestinal and ocular infections. 6 Garcia refers to microsporidial spores as acid-fast variable.…”

Section: Acid-fast Stainmentioning

confidence: 99%