Microsporidial keratoconjunctivitis - first outbreak in Japan.
Anterior segment optical coherence tomography (AS-OCT)
In vivo confocal biomicroscopy (IVCM)
Microsporidial keratoconjunctivitis
Polymerase chain reaction (PCR)
Vittaforma corneae
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
01 Nov 2023
01 Nov 2023
Historique:
received:
28
06
2023
accepted:
30
10
2023
medline:
3
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
epublish
Résumé
Most cases of microsporidial keratoconjunctivitis are found in the Southern hemisphere. Our purpose was to investigate the first outbreak of microsporidial keratoconjunctivitis in Japan among healthy, immunocompetent soccer players from the same team during a 1-month period. This study is an observational case series. The medical records were analyzed for five cases with microsporidial keratoconjunctivitis who presented within September 2022. All five cases were males between 28 and 36 years old. These previously healthy individuals belonged to the same football team. Their eyes were considered susceptible to contaminated water or dirt from the turf at game and practice sites. All cases involved unilateral conjunctivitis, with scattered round white lesions that showed positive fluorescein staining in the corneal epithelium. All cases experienced diminution of vision in the affected eye. In three cases, direct smears showed spores of approximately 2-3 μm in diameter. Polymerase chain reaction (PCR) analysis of corneal scrapes revealed partial amplification of microsporidial 18 S ribosomal RNA gene in four cases. Sequences of PCR products from all four cases showed 100% identity with strains of Vittaforma corneae previously reported from an outbreak in Singapore. All cases were treated with topical therapy, including voriconazole, fluorometholone, and levofloxacin. Four eyes underwent corneal scraping. After treatment, all eyes healed without residual opacities. Only a few sporadic case reports of this disease have previously been reported in Japan. We detected V. corneae in our case series, representing what appears to be the first outbreak of microsporidial keratoconjunctivitis in Japan. Exposure to contaminated water or soil, in addition to inadequate sanitary facilities, represents a potential source of infection. Further investigations to clarify the characteristics of microsporidia seem warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Most cases of microsporidial keratoconjunctivitis are found in the Southern hemisphere. Our purpose was to investigate the first outbreak of microsporidial keratoconjunctivitis in Japan among healthy, immunocompetent soccer players from the same team during a 1-month period.
CASE PRESENTATION
METHODS
This study is an observational case series. The medical records were analyzed for five cases with microsporidial keratoconjunctivitis who presented within September 2022. All five cases were males between 28 and 36 years old. These previously healthy individuals belonged to the same football team. Their eyes were considered susceptible to contaminated water or dirt from the turf at game and practice sites. All cases involved unilateral conjunctivitis, with scattered round white lesions that showed positive fluorescein staining in the corneal epithelium. All cases experienced diminution of vision in the affected eye. In three cases, direct smears showed spores of approximately 2-3 μm in diameter. Polymerase chain reaction (PCR) analysis of corneal scrapes revealed partial amplification of microsporidial 18 S ribosomal RNA gene in four cases. Sequences of PCR products from all four cases showed 100% identity with strains of Vittaforma corneae previously reported from an outbreak in Singapore. All cases were treated with topical therapy, including voriconazole, fluorometholone, and levofloxacin. Four eyes underwent corneal scraping. After treatment, all eyes healed without residual opacities.
CONCLUSIONS
CONCLUSIONS
Only a few sporadic case reports of this disease have previously been reported in Japan. We detected V. corneae in our case series, representing what appears to be the first outbreak of microsporidial keratoconjunctivitis in Japan. Exposure to contaminated water or soil, in addition to inadequate sanitary facilities, represents a potential source of infection. Further investigations to clarify the characteristics of microsporidia seem warranted.
Identifiants
pubmed: 37915107
doi: 10.1186/s12879-023-08767-y
pii: 10.1186/s12879-023-08767-y
pmc: PMC10621313
doi:
Substances chimiques
Water
059QF0KO0R
Types de publication
Observational Study
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
752Informations de copyright
© 2023. The Author(s).
Références
Am J Trop Med Hyg. 2018 Jul;99(1):90-93
pubmed: 29692301
Indian J Ophthalmol. 2018 Sep;66(9):1327-1328
pubmed: 30127158
Diagn Microbiol Infect Dis. 2007 Feb;57(2):163-7
pubmed: 17020796
Indian J Ophthalmol. 2021 May;69(5):1089-1094
pubmed: 33913839
J Xray Sci Technol. 2013;21(1):103-10
pubmed: 23507856
Clin Microbiol Rev. 1999 Apr;12(2):243-85
pubmed: 10194459
Ocul Surf. 2023 Apr;28:364-377
pubmed: 34419638
Ophthalmology. 2003 Jul;110(7):1420-5
pubmed: 12867402
Ophthalmology. 2006 Apr;113(4):531-7
pubmed: 16488011
Cornea. 2019 Aug;38(8):943-947
pubmed: 31276457
Ophthalmol Ther. 2020 Jun;9(2):265-278
pubmed: 32157613
Clin Microbiol Rev. 1994 Oct;7(4):426-61
pubmed: 7834600
Arch Ophthalmol. 2004 Feb;122(2):283-4
pubmed: 14769611
Clin Microbiol Rev. 2021 Dec 15;34(4):e0001020
pubmed: 34190570
Am J Ophthalmol. 2012 Dec;154(6):927-933.e1
pubmed: 22959880
Vet Parasitol. 2004 Dec 9;126(1-2):145-66
pubmed: 15567583
Surv Ophthalmol. 2011 Jan-Feb;56(1):1-22
pubmed: 21071051
Am J Ophthalmol. 2014 Jun;157(6):1151-5
pubmed: 24589573
Ophthalmology. 2009 Dec;116(12):2348-53
pubmed: 19815287
Indian J Ophthalmol. 2021 Jun;69(6):1537-1543
pubmed: 34011737
Eye (Lond). 2013 Jun;27(6):747-54
pubmed: 23598669
Indian J Ophthalmol. 2018 May;66(5):691-692
pubmed: 29676317
Clin Exp Ophthalmol. 2012 Jul;40(5):512-8
pubmed: 22003887
Emerg Infect Dis. 2013;19(9):1484-6
pubmed: 23965938
Ophthalmology. 2001 May;108(5):976-8
pubmed: 11320030
Am J Ophthalmol. 2018 Oct;194:101-109
pubmed: 30055152