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Clinical Spectrum of Microsporidial Kerato-conjunctivitis.
MedLine Citation:
PMID:  22003887     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The purpose of this paper was to analyse the causes, pathogenesis, diagnostic modalities and treatment outcomes of Microsporidial Kerato-Conjunctivitis (MKC). Microsporidia are increasingly recognized as opportunistic infectious pathogens in immunocompromised patients causing kerato-conjunctivitis. In the recent years, there has been a surge in reports of MKC in immunocompetent individuals presenting with stromal keratitis. A detailed literature search was done using Medline, OVID, Cochrane Library, UptoDate and Google Scholar databases with the terms microsporidia, keratitis, conjunctivitis, immunocompromised and immunocompetent. The articles were reviewed to determine the spectrum of clinical presentation, disease course, investigations, treatment modalities and outcome. Thirty-five publications were reviewed and 151 cases of MKC were included for this review. The main presenting features included pain, redness, photophobia, epiphora and blurring of vision. Duration of the symptoms lasted between 4 days -18 months. Light microscopy with modified trichrome stain was most commonly used to diagnose MKC. Resolution of symptoms was most commonly achieved with oral albendazole and/or topical fumidil B. Topical fluoroquinolones are also effective as a monotherapy as suggested by recent studies. Clinical outcome was good (visual acuity ≤ 6/12) for the patients who presented earlier (≤ 1 month) (75% of cases with documented final BCVA). MKC occurs more commonly in immunocompetent individuals than expected and can be diagnosed in earlier stages. From our review, we conclude that the patients, who were diagnosed early and treated, had complete resolution of symptoms with a better clinical outcome.
Authors:
Alex Chengyao Tham; Sanjay Srinivasan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-17
Journal Detail:
Title:  Clinical & experimental ophthalmology     Volume:  -     ISSN:  1442-9071     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896531     Medline TA:  Clin Experiment Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Journal compilation © 2011 Royal Australian and New Zealand College of Ophthalmologists.
Affiliation:
Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore Eye Clinic, Jurong Medical Centre, Singapore.
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