| CASE REPORT |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 283-284 |
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Refractory keratitis – A microbial cocktail or infectious enigma?
Ritika Mukhija1, Abhijeet Beniwal2, Kumar Kartikay Rajaura2, Seema Kashyap3, Radhika Tandon2
1 Cornea and Anterior Segment Fellow, Sussex Eye Hospital, United Kingdom
2 Department of Ophthalmology, RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
3 Department of Pathology, Ocular Pathology Section, RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
Correspondence Address:
Radhika Tandon
Department of Ophthalmology, RP Centre for Ophthalmic Sciences, AIIMS, New Delhi
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_3151_22
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A 39-year-old adult male presented to the outpatient department of a tertiary care eye hospital with keratouveitis and responded to treatment for viral keratouveitis. On a follow-up, the clinically ulcer suggested fungal keratitis, which was supported by in vivo confocal scan. The episode was managed with antifungal therapy. Tear film polymerase chain reaction (PCR) found cytomegalovirus DNA. Repeated episodes were likewise managed, but ultimately there was stromal scarring which required penetrating keratoplasty. Surprisingly, histopathology of specimen showed microsporidia. Till last follow-up, the graft was clear and the patient had 20/40 vision. Microsporidia should be a differential in refractory stromal keratitis.
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