Clinical Analyses of 4 Cases of Microsporidial Keratoconjunctivitis

IF 1.2 3区 农林科学 Q4 PARASITOLOGY
Yang Zhang, Shanshan Xu, Yingnan Xu
{"title":"Clinical Analyses of 4 Cases of Microsporidial Keratoconjunctivitis","authors":"Yang Zhang,&nbsp;Shanshan Xu,&nbsp;Yingnan Xu","doi":"10.1007/s11686-025-01010-5","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To report four cases of microsporidial keratoconjunctivitis (MKC) from The Affiliated Eye Hospital of Nanjing Medical University (from May 2023 to October 2024) and to aid ophthalmologists in diagnosing and treating MKC, as MKC has been increasingly reported in Asian healthy individuals but not much in Mainland China.</p><h3>Methods</h3><p>Four patients with MKC were studied. Demographic information, symptoms, and clinical data were collected. Diagnosis involved ophthalmic examinations, corneal scraping microscopy (including Giemsa staining, modified Ziehl-Neelsen staining, Calcofour white staining), bacterial and fungal cultures, and metagenomic next-generation sequencing (mNGS). Treatment included various topical medications like polyhexamethylene biguanide (PHMB), fluconazole, tacrolimus, sodium hyaluronate, and systemic medication such as albendazole.</p><h3>Results</h3><p>Three cases were caused by Encephalitozoon hellem proved by mNGS. Patients had symptoms like eye redness, swelling, pain, foreign body sensation, and vision loss. Risk factors included improper contact lens - wearing habits, contact with birds, or exposure to potentially contaminated environments. All patients showed improvements after treatment, with 3 cases cured and 1 case improved.</p><h3>Conclusion</h3><p>MKC is a unilateral, acute, non-purulent ocular surface infectious disease. Clinicians should be more aware of it. Diagnosis depends on recognizing clinical signs, exploring risk factors, and laboratory tests. There is no consensus on treatment, but combined topical and systemic anti-protozoal drugs showed good results. Further large-scale validation is needed. Relevant departments should strengthen water source management, and patients should pay attention to personal hygiene.</p></div>","PeriodicalId":6932,"journal":{"name":"Acta Parasitologica","volume":"70 2","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11686-025-01010-5.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Parasitologica","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s11686-025-01010-5","RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PARASITOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

To report four cases of microsporidial keratoconjunctivitis (MKC) from The Affiliated Eye Hospital of Nanjing Medical University (from May 2023 to October 2024) and to aid ophthalmologists in diagnosing and treating MKC, as MKC has been increasingly reported in Asian healthy individuals but not much in Mainland China.

Methods

Four patients with MKC were studied. Demographic information, symptoms, and clinical data were collected. Diagnosis involved ophthalmic examinations, corneal scraping microscopy (including Giemsa staining, modified Ziehl-Neelsen staining, Calcofour white staining), bacterial and fungal cultures, and metagenomic next-generation sequencing (mNGS). Treatment included various topical medications like polyhexamethylene biguanide (PHMB), fluconazole, tacrolimus, sodium hyaluronate, and systemic medication such as albendazole.

Results

Three cases were caused by Encephalitozoon hellem proved by mNGS. Patients had symptoms like eye redness, swelling, pain, foreign body sensation, and vision loss. Risk factors included improper contact lens - wearing habits, contact with birds, or exposure to potentially contaminated environments. All patients showed improvements after treatment, with 3 cases cured and 1 case improved.

Conclusion

MKC is a unilateral, acute, non-purulent ocular surface infectious disease. Clinicians should be more aware of it. Diagnosis depends on recognizing clinical signs, exploring risk factors, and laboratory tests. There is no consensus on treatment, but combined topical and systemic anti-protozoal drugs showed good results. Further large-scale validation is needed. Relevant departments should strengthen water source management, and patients should pay attention to personal hygiene.

4 例小孢子菌性角结膜炎的临床分析
摘要目的报告南京医科大学附属眼科医院2023年5月至2024年10月收治的4例微孢子性角膜结膜炎(MKC),以帮助眼科医生诊断和治疗MKC,因为MKC在亚洲健康人群中的报道越来越多,而在中国大陆的报道却不多。方法对4例MKC患者进行分析。收集了人口统计信息、症状和临床数据。诊断包括眼科检查、角膜刮痧显微镜(包括Giemsa染色、改良Ziehl-Neelsen染色、Calcofour白色染色)、细菌和真菌培养以及新一代宏基因组测序(mNGS)。治疗包括各种局部药物,如聚六亚甲基双胍(PHMB)、氟康唑、他克莫司、透明质酸钠和全身药物,如阿苯达唑。结果3例经mNGS证实为脑线虫所致。患者的症状包括眼睛发红、肿胀、疼痛、异物感和视力丧失。危险因素包括不正确的隐形眼镜佩戴习惯,与鸟类接触,或暴露在潜在污染的环境中。治疗后所有患者均有改善,治愈3例,好转1例。结论mkc是一种单侧、急性、非化脓性眼表感染性疾病。临床医生应该更多地意识到这一点。诊断依赖于识别临床症状,探索危险因素和实验室检查。治疗方法尚无共识,但局部和全身联合抗原虫药物显示出良好的效果。需要进一步的大规模验证。有关部门要加强水源管理,患者要注意个人卫生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Acta Parasitologica
Acta Parasitologica 医学-寄生虫学
CiteScore
3.10
自引率
6.70%
发文量
149
审稿时长
6-12 weeks
期刊介绍: Acta Parasitologica is an international journal covering the latest advances in the subject. Acta Parasitologica publishes original papers on all aspects of parasitology and host-parasite relationships, including the latest discoveries in biochemical and molecular biology of parasites, their physiology, morphology, taxonomy and ecology, as well as original research papers on immunology, pathology, and epidemiology of parasitic diseases in the context of medical, veterinary and biological sciences. The journal also publishes short research notes, invited review articles, book reviews. The journal was founded in 1953 as "Acta Parasitologica Polonica" by the Polish Parasitological Society and since 1954 has been published by W. Stefanski Institute of Parasitology of the Polish Academy of Sciences in Warsaw. Since 1992 in has appeared as Acta Parasitologica in four issues per year.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信