MyMedR

Fulltext Conjunctiva Necrosis Following Subconjunctival Amphotericin B Injection in Fungal Keratitis

Han Shu T, Hussein A, Kursiah MR

Cureus, 2019 Sep 05;11(9):e5580.

A 30-year-old Bangladeshi gentleman presented with history of sand entering his left eye and was diagnosed as having fungal keratitis by private ophthalmologist. He was treated with three doses of conventional subconjunctival amphotericin B injections (1.5 mg of amphotericin B and 1.2 mg of deoxycholate) over the inferior bulbar conjunctiva and topical antibiotics. Subsequently, he developed conjunctival necrosis over the site of injections and there was no clinical improvement of the keratitis. He was then treated with intensive antifungal and antibiotics eye drops. Debridement of epithelial plug was done and he was given intracameral amphotericin B injection. There was gradual improvement observed then with conjunctival epithelialization. The conjunctival tissue was completely healed after three months along with the corneal ulcer. Subconjunctival injection of Amphotericin B (AMB) may be considered as an adjunct therapy in severe fungal keratitis to address the issue of compliance. Close monitoring is needed due to its known complication of scleritis, scleral thinning and conjunctival necrosis. Liposomal AMB which is known to cause less toxicity given via subconjunctival injection in human subjects needs to be further studied.

Matched MeSH terms: Eye Infections, Fungal

Cladosporium cladosporioides keratomycosis: a case report

Chew FLM, Subrayan V, Chong PP, Goh MC, Ng KP

Jpn. J. Ophthalmol., 2009 Nov;53(6):657-659.

PMID: 20020251 DOI: 10.1007/s10384-009-0722-3

Matched MeSH terms: Eye Infections, Fungal/diagnosis; Eye Infections, Fungal/drug therapy; Eye Infections, Fungal/microbiology*

Fulltext Chronic endogenous fungal endophthalmitis: diagnostic and treatment challenges: A case report

Abu Talib DN, Yong MH, Nasaruddin RA, Che-Hamzah J, Bastion MC

Medicine (Baltimore), 2021 Apr 09;100(14):e25459.

PMID: 33832156 DOI: 10.1097/MD.0000000000025459

RATIONALE: Endogenous fungal endophthalmitis (EFE) is a sight-threatening complication of systemic fungemia. As the prevalence rises, treatment remains a challenge especially when there is a failure in first-line treatment or drug-resistant fungus. This case report studies a case of chronic EFE, focusing on the diagnostic procedures, treatment options, monitoring parameters and the treatment outcome.

PATIENT CONCERNS: A 64-year-old man with underlying well controlled diabetes mellitus was treated with 2 weeks' course of intravenous antifungal fluconazole for pyelonephritis as his blood culture grew Candida albicans. Concurrently, he complained of 3 months of bilateral painless progressive blurring of vision. At presentation, his visual acuity (VA) was light perception both eyes. Ocular examination revealed non granulomatous inflammation with dense vitritis of both eyes.

DIAGNOSIS: He was diagnosed with EFE but the condition responded poorly with the medications.

INTERVENTIONS: He was treated with intravitreal (IVT) amphotericin B and fluconazole was continued. Vitrectomy was performed and intraoperative findings included bilateral fungal balls in the vitreous and retina with foveal traction in the left eye. Postoperatively, vision acuity was 6/24, N8 right eye and 2/60, N unable for left eye with extensive left macular scar and hole. Vitreous cultures were negative. He received multiple IVT amphotericin B and was started on topical steroid eye drops for persistent panuveitis with systemic fluconazole. Ocular improvement was seen after switching to IVT and topical voriconazole. Despite this, his ocular condition deteriorated and he developed neovascular glaucoma requiring 3 topical antiglaucoma agents. Panretinal photocoagulation was subsequently performed.

OUTCOMES: At 3 months' follow-up, his vision acuity remained at 6/24 for right eye and 2/60 for the left eye. There was no recurrence of inflammation or infection in both eyes.

LESSONS: Voriconazole could serve as a promising broad spectrum tri-azole agent in cases of failure in first-line treatment or drug-resistant fungus.

Matched MeSH terms: Eye Infections, Fungal/diagnosis*; Eye Infections, Fungal/therapy*

Fulltext Bartonella henselae Neuroretinitis: A Rare Coinfection in POEMS Syndrome

Ab Kahar MEPI, Muhammed J, Hitam WHW, Husin A

Turk J Ophthalmol, 2020 12 29;50(6):371-376.

PMID: 33389938 DOI: 10.4274/tjo.galenos.2020.83873

Bartonella henselae is a recognized cause of neuroretinitis in cat scratch disease. Meanwhile, polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome with Castleman disease (evidence of lymph node hyperplasia), is a chronic debilitating condition that predisposes to various superimposed infections. B. henselae neuroretinitis implicated in POEMS syndrome has not been reported previously. A 34-year-old asymptomatic man was referred for an eye assessment. Examination showed visual acuity of 6/18 in the right eye and 6/24 in the left eye. On fundus examination, both eyes exhibited typical features of neuroretinitis (optic disc swelling and incomplete macular star). There was otherwise no vitritis or chorioretinitis. Serology for B. henselae revealed high immunoglobulin M (IgM) titer (1:96) indicative of acute disease, and positive immunoglobulin G (IgG) (1:156). He was treated with oral azithromycin for 6 weeks and a short course of oral prednisolone. Subsequently, the visual acuity in both eyes improved with resolution of macular star. However, both optic discs remained swollen.

Matched MeSH terms: Eye Infections, Bacterial/complications; Eye Infections, Bacterial/diagnosis*; Eye Infections, Bacterial/microbiology

Fulltext Bacterial and fungal keratitis in Upper Egypt: in vitro screening of enzymes, toxins and antifungal activity

Gharamah AA, Moharram AM, Ismail MA, Al-Hussaini AK

Indian J Ophthalmol, 2014 Feb;62(2):196-203.

PMID: 24008795 DOI: 10.4103/0301-4738.116463

This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents.

Matched MeSH terms: Eye Infections, Bacterial/drug therapy; Eye Infections, Bacterial/microbiology; Eye Infections, Bacterial/epidemiology*; Eye Infections, Fungal/drug therapy; Eye Infections, Fungal/microbiology; Eye Infections, Fungal/epidemiology*

Assessment of polymerase chain reaction in the detection of pseudomonas aeruginosa in contact lens-induced severe infectious keratitis

Subrayan V, Peyman M, Lek Yap S, Mohamed Ali NA, Devi S

Eye Contact Lens, 2010 Jul;36(4):201-3.

PMID: 20531205 DOI: 10.1097/ICL.0b013e3181e3efa3

PURPOSE: The aim of this study is to evaluate the role of real-time polymerase chain reaction (PCR) and conventional bacterial culture methods in the detection of Pseudomonas aeruginosa in contact lens-induced severe, partially treated corneal ulcers referred to a tertiary center.
METHODS: The study duration was 6 months. All patients with contact lens-related corneal ulcer, requiring admission during the study period were recruited. Samples from corneal scrapings were simultaneously sent at the time of admission for PCR and culture testing. An in-house real-time PCR was developed to detect the P. aeruginosa lasA gene. The results of PCR and culture were compared using McNemar's chi2 test.
RESULTS: Ten patients were recruited. The mean age was 33 years (20-45 years). All the patients had contact lens-related keratitis (>4 mm) of which eight (80%) were found positive for P. aeruginosa by PCR or culture. There was no significant difference between PCR and culture in detecting P. aeruginosa (P<0.05).
CONCLUSIONS: PCR is, at least, as good as conventional cultures in detecting P. aeruginosa. It is a rapid assay as compared with culture, and early detection enables prompt treatment thus reducing the destructive effect of the organism on the cornea.

Matched MeSH terms: Eye Infections, Bacterial/diagnosis*; Eye Infections, Bacterial/drug therapy; Eye Infections, Bacterial/microbiology

Acute retinal necrosis complicating chickenpox in a healthy adult--a case report and review of literature

Tajunisah I, Reddy SC

Compr Ther, 2007;33(1):25-31.

PMID: 17984490

Acute retinal necrosis (ARN) is known to occur in conjunction with primary varicella or chickenpox infection. The majority of ARN cases reported in the literature were of milder form with mild to moderate vitritis, limited retinitis, and rare occurrence of retinal breaks or detachment that responded well to intravenous acyclovir, with or without oral prednisolone. We report a case of unilateral ARN with marked vitritis and retinal necrosis leading to retinal breaks following chickenpox in a 32-year-old healthy lady. This patient was successfully treated with intravenous acyclovir followed by oral acyclovir and orbital floor triamcinolone injections to contain the inflammation with barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity, and to our knowledge, orbital floor triamcinolone therapy was not used earlier to contain ARN inflammation.

Matched MeSH terms: Eye Infections, Viral/drug therapy; Eye Infections, Viral/etiology*

Acute retinal necrosis complicating chicken pox in a healthy adult: a case report and review of literature

Tajunisah I, Reddy SC

Ann Ophthalmol (Skokie), 2007;39(1):57-62.

PMID: 17914207

We report a case of unilateral acute retinal necrosis (ARN) with marked vitritis and retinal necrosis leading to retinal breaks following chicken pox successfully treated with intravenous acyclovir followed by oral acyclovir, orbital floor triamcinolone injections to contain the inflammation, and barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity and the novel use orbital floor triamcinolone therapy to contain ARN inflammation.

Matched MeSH terms: Eye Infections, Viral/diagnosis; Eye Infections, Viral/etiology; Eye Infections, Viral/virology

Actinomycetic corneal ulcer

Singh M, Kaur B

Eye (Lond), 1989;3 ( Pt 4):460-2.

PMID: 2606221

A rare case of keratoactinomycosis developing in the absence of any known ocular trauma is described. It showed a dramatic response to penicillin therapy. Steroids should be cautiously used in the presence of active corneal disease. This case highlights the importance of repeated examination of corneal scrapings.

Matched MeSH terms: Eye Infections, Fungal/complications*

Acanthamoeba keratitis: current status and urgent research priorities

Khan NA, Anwar A, Siddiqui R

Curr Med Chem, 2018 May 10.

PMID: 29745319 DOI: 10.2174/0929867325666180510125633

BACKGROUND: First discovered in the early 1970s, Acanthamoeba keratitis has remained a major eye infection and presents a significant threat to the public health, especially in developing countries. The aim is to present a timely review of our current understanding of the advances made in this field in a comprehensible manner and includes novel concepts and provides clear directions for immediate research priorities.

METHOD: We undertook a search of bibliographic databases for peer-reviewed research literature and also summarized our published results in this field.

RESULTS: The present review focuses on novel diagnostic and therapeutic strategies in details which can provide access to management and treatment of Acanthamoeba keratitis. This coupled with the recently available genome sequence information together with high throughput genomics technology and innovative approaches should stimulate interest in the rational design of preventative and therapeutic measures. Current treatment of Acanthamoeba keratitis is problematic and often leads to infection recurrence. Better understanding of diagnosis, pathogenesis, pathophysiology and therapeutic regimens, would lead to novel strategies in treatment and prophylaxis.

Matched MeSH terms: Eye Infections

Fulltext A rare case of subretinal cysticercosis

Nor Zainura Z, Barkeh HJ, Wong JS, Muhaya M

Med J Malaysia, 2005 Dec;60(5):650-2.

PMID: 16515120

This is a case of a 25 year old lady whose eye had been infected by cysticercosis. This case highlighted that the inflammation was due to host immune response. She was treated with oral corticosteroid and the lesions regressed.

Matched MeSH terms: Eye Infections, Parasitic/diagnosis*

Fulltext A case report of ocular toxocariasis

Azira NM, Zeehaida M

Asian Pac J Trop Biomed, 2011 Apr;1(2):164-5.

PMID: 23569750 DOI: 10.1016/S2221-1691(11)60018-X

Ocular toxocariasis is prevalent among children. The symptoms and signs may mimic other ocular pathologies such as malignancies and other infectious diseases (such as toxoplasmosis and syphilis). We presented a case of progressive blurring of vision in a single eye of a 9-year-old boy. The presence of anti-toxocara antibody in serum samples helps to confirmation the diagnosis in our patient. Despite of treatment, the boy had lost his vision on the affected eye.

Matched MeSH terms: Eye Infections, Parasitic/immunology; Eye Infections, Parasitic/parasitology*

Displaying publications 41 - 52 of 52 in total