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.