[A case of microsporidial keratitis]

A case of keratitis caused by microsporidia infection was reported. A 57-year-old female patient, without any obvious predisposing cause, presented with eye redness, eye abrasion and vision loss for one year in the left eye. The patient was diagnosed with viral keratitis based on laboratory examinations and clinical symptoms two months ago in our hospital. He was given outpatient treatment for antivirus. Two months later, he was admitted to our hospital with worsened condition that presented with corneal ulcer. After admission, corneal scraping examination was performed for the detection of microsporidia with calcofluor white (CFW) and Ziehl-Neelsen staining, the smear revealed multiple oval spore-like structures, with acid-fast positive and showed blue fluorescence on potassium hydroxide with CFW stain, confirming a diagnosis of microsporidial keratitis in the left eye. Treatment: topical use of ofloxacin eye ointment and voriconazole eye drops was not effective, and then penetrating keratoplasty was performed, and the patient's condition was stable after surgery. At present, they are still in treatment and follow-up.