BILATERAL MICROSPORIDIAL KERATITIS IN AN PATIENT WITH AIDS

Introduction. Microsporidia are spore-forming, obligate intracellular protozoa. Humans seem to be infected only by 4 genera of microsporidia . Microsporidial keratoconjunctivitis in immunodeficient patients has a characteristic appearance. Case report. 34 year old woman with AIDS complained of bilateral blurred vision. The visual acuity was 0.6 on b oth eyes. She had a mild conjunctivitis and disseminate. not very prom inent intraepithelial corneal opacities. She was treated with propamid ine isethionate 0,1% 5 times daily and artificial rears under presumpt ive diagnosis of microsporidial keratoconjunctivitis. We discontinued this treatment because of no improvement. Within 6 months the visual a cuity decreased to 0,05. A conjunctival smear was positive for microsp oridia. Local Fumagillin-eye-drops 0,07 mg/ml 7 limes daily were given . Within 2 weeks an impressively improvement was seen. Because of an p ersisting diarrhea 400 mg Albendazol twice daily was added orally with out success. Discussion. The biomicroscopically changes of microsporid ial keratoconjunctivitis are characteristical and lead to the clinical diagnosis. Fumagillin is in vitro and clinically a potent antimicrosp oridian agent with an extremely broad therapeutic range.