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Outbreak of microsporidial keratoconjunctivitis with rugby sport due to soil exposure

A K H Kwok1, J M K Tong, B S F Tang

  • 1Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, China. alvinkwok@hksh.com

Eye (London, England)
|April 20, 2013
PubMed
Abstract

Insights

A rugby match outbreak of microsporidial keratoconjunctivitis affected 33 eyes in young individuals. A topical treatment of moxifloxacin and an antiseptic proved safe and effective for healing.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Microsporidial keratoconjunctivitis outbreaks can occur in previously healthy individuals.
  • Identifying the source and effective treatment for such infections is crucial, especially in pediatric populations.

Purpose of the Study:

  • To report the first documented outbreak of microsporidial keratoconjunctivitis linked to a sporting event (rugby match) in pediatric and teenage individuals.
  • To evaluate the efficacy and safety of a standardized topical treatment regimen.

Main Methods:

  • An observational case series analyzed medical records of 25 patients (33 eyes) presenting with keratoconjunctivitis post-rugby match.
  • Corneal scrapings were examined microscopically and via PCR for Vittaforma corneae.
  • Patients received a standardized topical treatment including moxifloxacin and an antiseptic (Brolene or Desomedine).

Main Results:

  • The outbreak involved 33 eyes of 25 individuals aged 5-16 years, with symptom onset 10-30 days after a rugby match.
  • PCR confirmed Vittaforma corneae in 3 of 5 tested eyes, with high sequence identity to known strains.
  • All affected eyes healed without sequelae following the standardized topical treatment.

Conclusions:

  • This study reports the first outbreak of microsporidial keratoconjunctivitis associated with a rugby match in a pediatric and teenage population.
  • A topical regimen combining a fluoroquinolone (moxifloxacin) and an antiseptic demonstrated safety and effectiveness.
  • Further validation in treatment trials is recommended for this therapeutic approach.

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