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Patients (mean age 28.5 years, 13 F) showed Encephalitozoon hellem (65.0%), E. bieneusi (15.0%, first reported in MKC), and Vittaforma corneae (15.0%). Key risks included bird contact (70.0%, mostly psittacines), contact lens use (40.0%), and water exposure (15.0%). The most common symptom was redness (85.0%); limbal fluorescein positivity occurred in 65.0%. Topical 0.02% PHMB cured 90.0% of 20 cases; one recurrence followed treatment stop. Some E. hellem cases linked to parrots showed potential zoonotic transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MKC in China involves E. bieneusi and parrot-associated E. hellem. Limbal staining aids diagnosis; PHMB is effective. Zoonotic risks related to Psittacine birds and contact lens use require clinical attention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12348-026-00596-9","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:06:31Z","timestamp":1779422791000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical profile of microsporidial keratoconjunctivitis in healthy individuals of China \u2014new species and neglected risk factors"],"prefix":"10.1186","volume":"16","author":[{"given":"Yingnan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuguang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijing","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1301-6979","authenticated-orcid":false,"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"4","key":"596_CR1","doi-asserted-by":"publisher","first-page":"e0001020","DOI":"10.1128\/CMR.00010-20","volume":"34","author":"B Han","year":"2021","unstructured":"Han B, Pan G, Weiss LM (2021) Microsporidiosis in Humans. 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Informed consent was acquired from all 20 patients. Informed consent to participate was obtained from the parents or legal guardians of any participant under the age of 16.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from all participants for publication of their individual clinical details and ocular images in this manuscript. For minor participants under 16\u202fyears of age, written informed consent was obtained from their parents or legal guardians.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr Xu is associate Chief Physician, Deputy Director of Outpatient Department of The Affiliated Eye Hospital of Nanjing Medical University. Her research focuses on ocular pathogens, including the microsporidia, fungus and acanthamoeba, as well as contact - lens - related ocular surface problems.","order":3,"name":"Ethics","label":"Authors\u2019 information","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"43"}}