Microsporidial keratoconjunctivitis in a healthy contact lens wearer without human immunodeficiency virus infection

Purpose: To present a rare case of microsporidial keratoconjunctivitis in a n otherwise healthy contact lens wearer without human immunodeficiency viru s infection who responded to treatment with systemic albendazole and topica l fumagillin. Design: interventional case report. Method: A cornea epithelial scraping from a man with unilateral keratoconju nctivitis previously treated with topical steroids was evaluated by modifie d trichome staining. Main Outcome Measures: The patient was evaluated for his symptoms, visual a cuity, clinical observations, and pathologic examination of corneal scrapes . Results: Modified trichome staining of an epithelial corneal scraping revea led pinkish to red organisms characteristic of microsporidia. Results of a human immunodeficiency virus (HIV) enzyme-linked immunosorbent assay test w ere negative. The symptoms of ocular discomfort and clinical signs of kerat oconjunctivitis resolved after 2 months of treatment with albendazole and t opical fumagillin. Conclusions: Ocular infection with microsporidia, although classically occu rring in patients with HIV infection, may occur rarely in healthy individua ls, especially if previously treated with systemic immune suppression or to pical steroids. Microsporidial keratoconjunctivitis should be considered in the differential diagnosis of a contact lens wearer with atypical multifoc al diffuse epithelial keratitis. Ophthalmology 2001;108:976-978 (C) 2001 by the American Academy of Ophthalmology.