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Case Report: Microsporidial Endophthalmitis after Penetrating Eye Trauma
Gladys Rodrigues, Pooja Rao, Tishya Vepakomma1
1Department of Ophthalmology, Kasturba Medical College, Mangalore, India.
Significance:
In the recent past, there are increasing publications on microsporidia affecting the cornea in Asian population. However, microsporidia-causing endophthalmitis has been rarely reported. This report intends to draw the attention of eye care professionals to consider microsporidia as a differential diagnosis in cases of keratitis or endophthalmitis after ocular trauma.
Purpose:
The purpose of this study was to report a case of microsporidial endophthalmitis after corneal tear in an otherwise healthy patient.
Case Report:
A 62-year-old healthy gentleman sustained injury to the left eye cornea with the tip of a soiled and wet screw driver. Two days after the corneal tear suturing, he complained of pain. On examination, circumcorneal congestion with hypopyon of 2 mm in height was present. Vitreous tap and intravitreal antibiotics were injected. Vitreous tap showed microsporidia. Pars plana vitrectomy was performed. His vision improved to 6/12.
Conclusions:
Microsporidia are an emerging cause of stromal keratitis. In the recent past, there has been an increase in microsporidial keratitis in both immunocompetent and immunocompromised individuals. History of trauma especially in rainy season and exposure to soil are reported risk factors. This is a case report on microsporidia-causing endophthalmitis after corneal tear repair. Ophthalmologists and optometrists should be aware of the possibility of microsporidia as a potential pathogen causing stromal keratitis or endophthalmitis in a setting of ocular trauma. Early treatment can result in good visual recovery.
Insights
Microsporidia can cause endophthalmitis after corneal trauma, even in healthy individuals. Early diagnosis and treatment of microsporidial keratitis and endophthalmitis are crucial for good visual recovery.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Microsporidia are increasingly recognized as a cause of corneal infections, particularly in Asian populations.
- While microsporidial keratitis is more common, microsporidial endophthalmitis is rarely reported.
- Risk factors include ocular trauma, especially during the rainy season, and exposure to soil.
Observation:
- A case of microsporidial endophthalmitis following a corneal tear in a 62-year-old healthy male is presented.
- The patient presented with pain and hypopyon two days after corneal tear suturing.
- Microsporidia were identified in vitreous fluid samples.
Findings:
- Pars plana vitrectomy was performed, and the patient's vision improved to 6/12.
- This case highlights the potential for microsporidia to cause severe intraocular infection post-trauma.
- Prompt identification and intervention are key to successful outcomes.
Implications:
- Ophthalmologists and optometrists should consider microsporidia in the differential diagnosis of keratitis and endophthalmitis, especially after ocular trauma.
- Awareness of this emerging pathogen can lead to earlier diagnosis and treatment.
- Timely management of microsporidial endophthalmitis can prevent significant vision loss.
