scholarly journals Recalcitrant Paecilomyces keratitis

2019 ◽  
Vol 12 (4) ◽  
pp. e229226
Author(s):  
Seetha Lakshmi ◽  
Cristina Vanessa Garcia
Keyword(s):  
Antifungal Agents ◽  
Corneal Ulcer ◽  
Surgical Intervention ◽  
Caucasian Woman ◽  
Artificial Eye ◽  
Finger Counting ◽  
Intrastromal Injection ◽  
The Right ◽  
Continue Therapy

A 54-year-old Caucasian woman presented with corneal ulcer of the right eye of 4 weeks duration after scratching her cornea while removing her contact lens and artificial eye lashes. Her visual acuity was 20/32 (left eye) and finger counting (right eye). She had a 3x3 mm epithelial defect with underlying corneal oedema and hypopyon. Right eye cultures grew Paecilomyces species. Topical and systemic antifungal agents were initiated. Due to the sight-threatening disease, the patient underwent surgical intervention with intrastromal injection of amphotericin B and a large conjunctival flap covering 75% of the right eye corneal ulcer. After 3 months of therapy, she had near-complete resolution of the corneal ulcer. Unfortunately, recurrence of the corneal ulcer occurred within 3 weeks of cessation of therapy, prompting reinitiation of ophthalmic and systemic antifungal agents. The patient was advised to continue therapy for 6 months with regular follow-up.

Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience

2020 ◽  
Vol 30 (3) ◽  
pp. 409-412
Author(s):  
Murat Surucu ◽  
İlkay Erdoğan ◽  
Birgül Varan ◽  
Murat Özkan ◽  
N. Kürşad Tokel ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Systolic Pressure ◽  
Presenting Symptoms ◽  
Long Term Follow Up ◽  
The Right

AbstractObjective:Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery.Methods:We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated.Results:Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1).Conclusion:The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.

scholarly journals The Use of Intravitreal Ranibizumab for Choroidal Neovascularization Associated with Vogt-Koyanagi-Harada Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
A. M. Kolomeyer ◽  
M. S. Roy ◽  
D. S. Chu
Keyword(s):  
Vision Loss ◽  
Corticosteroid Treatment ◽  
Exudative Retinal Detachment ◽  
Intravitreal Ranibizumab ◽  
Loss To Follow Up ◽  
Finger Counting ◽  
Combinational Treatment ◽  
Vkh Syndrome ◽  
The Right

Purpose. To describe the use of intravitreal ranibizumab for choroidal neovascular membrane (CNVM) secondary to Vogt-Koyanagi-Harada (VKH) syndrome.Methods. Interventional case report.Results. A 50-year-old woman presented with conjunctival injection and bilateral eye pain. Vision was 20/400 and 20/80 in the right and left eyes, respectively. Bilateral iritis, vitritis, and choroidal thickening were evident. Exudative retinal detachment was present in the left eye. Corticosteroid treatment improved vision to 20/40 bilaterally. Methotrexate (MTX) was initiated and vision remained stable for 3 months. After a 5-month loss to follow-up, vision in the left eye decreased to finger counting (CF) and a parafoveal CNVM was identified. After 3 intravitreal ranibizumab injections, vision improved to 20/40. Twelve months later, despite inflammation control, vision decrease to CF due to recurrent CNVM. A fourth ranibizumab injection was given. Twenty months later, best-corrected vision was 20/400, and an inactive CNVM was present in the left eye.Conclusion. After initial CNVM regression and visual acuity improvement due to ranibizumab, the CNVM recurred and became refractory to treatment. Despite control of inflammation and neovascularization, VKH chronicity lead to permanent vision loss in our patient. A combinational treatment approach may be required in such patients.

scholarly journals Disseminated Coccidioidomycosis of the Knee Joint Requiring Synovectomy and Arthrotomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Farhan Ahmad ◽  
Kavina Patel ◽  
Jorge Clint De Leon ◽  
Frank A Buttacavoli
Keyword(s):  
Infectious Disease ◽  
Fungal Infection ◽  
Orthopedic Surgery ◽  
Surgical Intervention ◽  
History Of ◽  
The Right ◽  
United States Mexico ◽  
Comprehensive History ◽  
Fat Pads

Introduction: Coccidioidomycosis is a fungal infection endemic to the Southwestern United States, Mexico, and South America. While uncommon, inhalation of spores or direct cutaneous contact can lead to disseminated infection in the immunocompetent, with the involvement of the musculoskeletal and integumentary systems. Case Report: A 49-year-old patient with a history of pulmonary coccidioidomycosis presented with the right knee pain and multiple symptomatic abscesses beneath the suprapatellar and infrapatellar fat pads. Arthrocentesis and culture confirmed the infection, and open synovectomy, arthrotomy, and drainage of the infection were performed without complication. Conclusion: Disseminated coccidioidomycosis is an uncommon fungal infection that may involve joints and become refractory to pharmacotherapy. Management may require surgical intervention, along with infectious disease consultation and close follow-up. Patients from endemic regions should be evaluated with a comprehensive history of this disease. Keywords: Coccidioidomycosis, knee, septic arthritis, arthrotomy, synovectomy, orthopedic surgery, fungal infection.

scholarly journals First Experience of Ankle Joint Arthroplasty in a Giant Cell Tumor of the Tibial Epiphysiometaphys: Case Report and Literature Review

2017 ◽  
pp. 56-61
Author(s):  
A. I. Snetkov ◽  
G. N. Berchenko ◽  
A. R. Frantov ◽  
S. Yu. Batrakov ◽  
R. S. Kotlyarov ◽  
...  
Keyword(s):  
Case Report ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Ankle Joint ◽  
Surgical Intervention ◽  
Joint Arthroplasty ◽  
Cell Tumor ◽  
Custom Made ◽  
The Right

Case report for the 18 years old female patient with a giant cell tumor of the distal articular end of the right tibia is presented. The surgical intervention included segmental resection of the articular end of the right tibia and substitution of the defect with the custom-made ankle endoprosthesis. The follow up period made up 4 years. The range of motion in the right ankle joint was satisfactory, no relapse occurred and the implant components were stable. 

First Clinical Experience with Anti-myelin Oligodendrocyte Glycoprotein Antibody-Positive Optic Neuritis

2020 ◽  
Vol 237 (04) ◽  
pp. 458-463 ◽  
Author(s):  
Jan Heckmann ◽  
Margarita Todorova ◽  
Stefanie Müller ◽  
Philip Julian Broser ◽  
Veit Sturm
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Pulse Therapy ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Individual Treatment ◽  
Igg Antibodies ◽  
Intravenous Methylprednisolone ◽  
Finger Counting ◽  
The Right

Abstract Background Antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been consistently found in a range of demyelinating disorders. In this context, MOG-IgG-associated optic neuritis (ON) has been suggested as a new subset of optic neuropathy. However, clinical manifestations and distinctive characteristics have only rarely been described. Patients and Methods A retrospective case series of three patients with MOG-IgG-associated ON. Clinical morphological features using imaging techniques are presented. Results Three patients (8-year-old boy, 28-year-old female, 48-year-old male) were included. An 8-year-old boy suffered from a bilateral ON with severe visual loss. The best-corrected visual acuity (BCVA) was 0.05 in the right eye and finger counting in the left eye. The patient had a previous episode of acute disseminated encephalomyelitis (ADEM) with a right abducens nerve palsy. Visual acuity recovered after repeated cycles of intravenous methylprednisolone pulse therapy and 10 cycles of plasma exchange. During the last follow-up, BCVA was 0.9 in the right eye and 0.8 in the left eye. A 28-year-old female presented with a bilateral ON. Her BCVA was 0.5 in the right eye and 0.8 in the left eye. She fully recovered with pulse methylprednisolone therapy (1000 mg/d) with tapering after the second cycle and had a BCVA of 1.0 during the last follow-up visit. A 48-year-old male suffered from a relapsing bilateral ON. At first presentation, BCVA was 0.1 in the right eye and finger counting in the left eye. BCVA fully recovered after each pulse therapy with intravenous methylprednisolone (two cycles). Since the first relapse, the patient has been receiving long-term immunosuppression with rituximab. Despite rituximab and low-dose oral prednisone, the patient had another relapse with a left ON. After a third cycle with intravenous methylprednisolone, he partially recovered. BCVA at last follow-up was 1.0 in the right and 0.8 in the left eye. Conclusions MOG-IgG antibodies have been identified in different acquired demyelinating syndromes. The patients reported had an ADEM followed by bilateral ON, an isolated bilateral ON, and a relapsing bilateral ON. Individual treatment strategies led to substantial visual recovery in all patients. We recommend inclusion of MOG-IgG antibodies in the diagnostic workup at least after the first recurrence of ON since they can serve as a diagnostic and potential prognostic tool and might lead to specific therapeutic recommendations.

Surgical management of radial head luxation in a dog using an external skeletal traction device

2013 ◽  
Vol 26 (02) ◽  
pp. 140-146 ◽  
Author(s):  
R. Yeadon ◽  
M. Farrell ◽  
N. Fitzpatrick
Keyword(s):  
Radial Head ◽  
Surgical Intervention ◽  
Skeletal Traction ◽  
Thoracic Limb ◽  
Consolidation Phase ◽  
Traction Device ◽  
History Of ◽  
Reaction Forces ◽  
The Right

SummaryA five-month-old Airedale Terrier was presented with a history of right thoracic limb lameness. Clinical and radiographic examinations revealed caudolateral luxation of the right radial head. Surgical intervention involved an oblique proximal radial osteotomy and gradual craniomedial traction of the radial head using an external skeletal fixator (ESF) incorporating a traction device. The radial head was gradually reduced over 16 days. After radiographic confirmation of appropriate radial head reduction, a consolidation phase followed, with removal of the traction ESF after 24 days. Follow-up radiographs documented remodelling of the radial head. Clinical follow-up three years postoperatively revealed nearly normal ground reaction forces. Activity was unrestricted and there was no requirement for analgesic medications.

An Unusual Case of Three Synchronous Tumors in a Young Woman

2005 ◽  
Vol 91 (3) ◽  
pp. 267-269 ◽  
Author(s):  
Raffaele Longo ◽  
Guido Carillio ◽  
Antonietta Torrisi ◽  
Maria Pia Tocco ◽  
Giovanni Battista Grassi ◽  
...  
Keyword(s):  
Left Lung ◽  
Wide Resection ◽  
Clear Correlation ◽  
Caucasian Woman ◽  
Synchronous Tumors ◽  
Sclerosing Hemangioma ◽  
Positron Emission ◽  
Chest X Ray ◽  
The Right

The occurrence in the same young patient of three synchronous tumors deriving from different embryogenic tissues and without a clear correlation with a common etiopathogenic factor is very unusual. We report a case of a Caucasian woman submitted to wide resection of a large retroperitoneal liposarcoma and right radical nephrectomy for suspected tumor infiltration. Histological examination of the right ureter and renal pelvis showed the presence of a multifocal urothelial carcinoma that was clinically asymptomatic. Two months later, during follow-up, chest X-ray and computed tomography documented a coin lesion of the upper left lung, confirmed by positron emission tomography. This nodule was surgically removed and examined histologically, resulting in a diagnosis of sclerosing hemangioma. The patient is alive without evidence of recurrent disease.

scholarly journals Successful surgical management of carcinoma lung in a 80 years old male

2016 ◽  
Vol 9 (2) ◽  
pp. 109
Author(s):  
Bidyut Kumar Biswas ◽  
Kazi Saiful Islam ◽  
Md. Aftabuddin
Keyword(s):  
Tumor Invasion ◽  
Surgical Intervention ◽  
Lung Tumor ◽  
The Body ◽  
Lung Field ◽  
Ct Guided ◽  
Adequate Evaluation ◽  
The Right ◽  
Malignant Lung Tumor

Carcinoma of the lung is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung by process of metastasis into nearby tissue or other parts of the body. Various surgical modalities have been used with the treatment of lung cancer with variable results. We report a case of 80 years- old male admitted to National Institute of Chest Diseases and Hospital with dry cough for one month and chest pain for twenty days. On his physical examination there was no significant abnormality. Hematological and biochemical findings were also normal. In his CXR -P/A view showed a rounded opacity in the right lung field. It was diagnosed as a case of Squamous Cell Carcinoma of the right upper lobe of lung by a CT guided FNAC.  We had performed segmentectomy of the lesion on right upper lobe by a right sided thoracotomy. Histopathological report confirmed the diagnosis and showed that the excised margins were free of tumor invasion. Patient’s recovery was uneventful. Patient was discharged on 15<sup>th</sup> post operative day with advice for further follow up and also referred to Oncology Department for further management. In conclusion this was a case of carcinoma lung which was successfully managed by surgical intervention due to judicious suspicion adequate evaluation and measures in time.

Case Study

2014 ◽  
Vol 4 (3) ◽  
pp. 46-55
Author(s):  
Vasudha Damle ◽  
Rahul Agarwal ◽  
Nitin Garg ◽  
Hanni V Gulwani
Keyword(s):  
Surgical Intervention ◽  
Histopathological Examination ◽  
Intracranial Extension ◽  
Diagnostic Dilemma ◽  
Metastatic Behavior ◽  
Vascular Insufficiency ◽  
The Right ◽  
Slow Growing

Hemangiopericytoma is a slow growing, vascular mesenchymal tumor, which may behave like a malignant tumor, leading to local recurrence, or metastasis, or both. This report is about a 32-year-old lady with non-axial proptosis and diminished vision due to a mass lesion in the superomedial quadrant of the right orbit. CT scan and MRI reports showed no intracranial extension. Surgical intervention was done through the roof of the orbit keeping hemangioma, neuroma or schwannoma as the leading differential diagnoses; however, on aspiration, it was not bleeding. It was confirmed to be a hemangiopericytoma on histopathological examination. The unique presentation, where, on tapping, no blood was found, makes this case an example of diagnostic dilemma. This lack of bleeding might be due to vascular insufficiency of the mass. Proptosis disappeared the following day after the surgery and vision also showed significant improvement to 20/20 within a week after surgery. The patient has been kept on regular follow up keeping in mind the recurrent and metastatic behavior of the tumor.

scholarly journals Persistence of the embryonic lateral marginal vein: report of two cases

2001 ◽  
Vol 56 (5) ◽  
pp. 159-162 ◽  
Author(s):  
Raúl Rojas Martinez ◽  
Pedro Puech-Leão ◽  
Guimarães Paulo Motta ◽  
Muraco Netto Baptista
Keyword(s):  
Surgical Intervention ◽  
Venous Malformation ◽  
Lower Limbs ◽  
Surgical Removal ◽  
Marginal Vein ◽  
Vascular Surgeon ◽  
Aesthetic Results ◽  
Rare Malformation ◽  
The Right

PURPOSE: Congenital venous malformations of the lower limbs represent a particular challenge for the vascular surgeon. Persistence of fetal veins is a rare malformation, and the most common is the persistence of the lateral marginal vein usually observed in patients with Klippel-Trenaunnay Syndrome. The persistence of this embryonic vein as an isolated venous malformation without the other characteristics of the Klippel-Trenaunnay Syndrome has not yet been reported. This paper describes two cases. METHODS: Two patients, a 17-year-old male patient and a 16-year-old female, have had since their birth a large venous trunk in the lateral aspect of the right leg and thigh. The limbs underwent duplex scanning and phlebography. The surgical removal of the lateral marginal vein was performed. RESULTS: Surgical treatment resulted in very good functional and aesthetic results. Follow-up at 26 months showed no evidence of varicose vein recurrence. CONCLUSIONS: To achieve good results, surgical intervention may be indicated in cases of orthopedic deformity, hemorrhage, symptomatic, and unaesthetic lesions.

Sign in / Sign up

Export Citation Format

Share Document