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J Med Microbiol 56 (2007), 1250-1252; DOI: 10.1099/jmm.0.47297-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Case Report

A case of bilateral microsporidial keratitis from Bangladesh – infection by an insect parasite from the genus Nosema

Alan Curry1, Hardeep Singh Mudhar2, Sumedh Dewan3, Elizabeth U. Canning4 and Bart E. Wagner5

1 Electron Microscopy, Clinical Sciences Building, Manchester Royal Infirmary, Manchester M13 9WL, UK

2 National Specialist Ophthalmic Pathology Service, Department of Histopathology, E Floor, Royal Hallamshire Hospital, Sheffield S10 2JF, UK

3 Cornea Clinic, Chittagong Eye Infirmary, PO Box 729, Pahartali, Chittagong 4000, Bangladesh

4 Department of Biological Sciences, Imperial College London, Silwood Park Campus, Ascot SL4 7PY, UK

5 Electron Microscopy Unit, Department of Histopathology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK

Correspondence
Alan Curry
Alan.curry{at}cmmc.nhs.uk
or
dracurry{at}btinternet.com

Received 19 March 2007
Accepted 16 May 2007

An HIV-negative patient from Bangladesh with bilateral keratitis was found to be infected with a microsporidian parasite belonging to the genus Nosema. Significantly, the patient had bathed in a rural pond 7 days prior to the development of ocular symptoms. Nosema parasites are common insect parasites and the source of this microsporidial infection was possibly from mosquito larvae developing in the pond in which the patient bathed. The reduced temperature of the human eye and its immune status may have allowed a poikilothermic insect parasite to establish infection in the cornea of a homeothermic human host. This case highlights the opportunistic potential of insect microsporidial parasites to infect immunocompetent humans as well as those who are immunodeficient.






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