scholarly journals Chronic Endophthalmitis Caused by Pseudomonas stutzeri

2020 ◽  
Vol 11 (3) ◽  
pp. 595-599
Author(s):  
Saeed T. Alshahrani ◽  
J. Fernando Arevalo
Keyword(s):  
Pseudomonas Stutzeri ◽  
Posterior Chamber ◽  
Topical Steroids ◽  
Sensitivity Testing ◽  
Corneal Incision ◽  
Presumptive Diagnosis ◽  
Lens Extraction ◽  
History Of ◽  
Sudden Decrease ◽  
The Right

A patient presented with complaints of a sudden decrease in vision, ocular redness, and pain in the right eye. The patient had a history of clear lens extraction with intraocular lens (IOL) implantation for myopia 2 years previously. He had been prescribed topical steroids for episodes of inflammation that occurred repeatedly every 1–2 months. With a presumptive diagnosis of chronic endophthalmitis, a 23-G transconjunctival sutureless pars plana vitrectomy (PPV) with delivery of intravitreal antibiotics was performed the next day. Culture sensitivity testing of the vitreous sample indicated <i>Pseudomonas stutzeri</i> that was sensitive to ceftazidime and gentamicin. Two weeks later, the patient presented with sudden loss of vision and all the signs of recurrent endophthalmitis. 23-G transconjunctival sutureless PPV was performed along with removal of the posterior chamber IOL through a corneal incision. Complete resolution was only achieved after removal of the IOL, resulting in excellent visual recovery. Due to its chronic and fulminating nature, <i>P. stutzeri</i> can induce endophthalmitis and should be considered in the differential diagnosis. Aseptic measures are the best prevention.

scholarly journals Tricuspid valve infective endocarditis in a non-IVDU patient with atopic dermatitis

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Heerani Woodun ◽  
Sarah Bouayyad ◽  
Sura Sahib ◽  
Nadir Elamin ◽  
Steven Hunter ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Intravenous Drug User ◽  
Blood Cultures ◽  
Topical Steroids ◽  
Foramen Ovale ◽  
History Of ◽  
The Right ◽  
Systemic Infections

Abstract A 29-year-old male, with chronic atopic dermatitis (AD), presented with a 2-week history of fatigue, pyrexia and weight loss. Examination showed eczematous patches with lichenified papules, erosions on the right shin and a new murmur. Blood cultures isolated methicillin-sensitive Staphylococcus aureus. Transthoracic echocardiography showed vegetation on the tricuspid valve (TV) that was adherent to the septal leaflet. He was treated for infective endocarditis, attributed to poorly controlled AD, with intravenous Flucloxacillin. Due to ongoing sepsis and pulmonary septic emboli, Clindamycin was added. He underwent TV repair; the septal leaflet was excised, and the remnant two leaflets were brought together with a ring. His patent foramen ovale was closed. His skin was treated with topical steroids and emollients. Right-sided endocarditis of an intact TV is uncommon in a non-intravenous drug user. Therefore, this novel case portrays the importance of aggressively managing AD as it is a risk factor for significant systemic infections.

scholarly journals Hypertrophic osteopathy and bone metastases in a dog with prostatic carcinoma

2020 ◽  
Vol 50 (8) ◽  
Author(s):  
Andréia Vielmo ◽  
Ronaldo Michel Bianchi ◽  
Letícia Franciele Gomes Kinappe ◽  
Cristiano Gomes ◽  
Saulo Petinatti Pavarini
Keyword(s):  
Bone Metastases ◽  
Prostatic Carcinoma ◽  
Prostate Gland ◽  
Periosteal Reaction ◽  
Radiographic Examination ◽  
Appendicular Skeleton ◽  
Presumptive Diagnosis ◽  
History Of ◽  
Satisfactory Clinical Response ◽  
The Right

ABSTRACT: Prostatic carcinomas in are aggressive neoplasms and bone metastases may occur; however, hypertrophic osteopathy associated with that condition is poorly documented. A ten-year-old, neutered male, mixed breed dog had a history of lameness and volume increase in the left pelvic limb. On radiographic examination, a lytic bone mass was observed in the left metatarsus, as well as a diffuse proliferative periosteal reaction in several bones of the appendicular skeleton, in addition to radiopaque nodular structures in all lung lobes. A presumptive diagnosis of primary bone neoplasia with pulmonary metastases and hypertrophic osteopathy was established and chemotherapy treatment was started. However, there was no satisfactory clinical response, and euthanasia was ellected. At necropsy, there was moderate enlargement of the prostate gland. The gland was firm and whitish, with a multilobulated aspect. Several similar masses were observed in the right kidney, lungs, mediastinal lymph nodes, and multiple bones of the appendicular skeleton. These bones also presented evident diffuse periosteal reaction. Histological examination revealed a metastatic prostatic carcinoma with bone involvement and hypertrophic osteopathy. This report is an unusual case of metastatic prostatic carcinoma in association with hypertrophic osteopathy and concomitant bone metastases.

scholarly journals Scleritis Caused byIn VitroLinezolid-ResistantNocardia asteroides

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Andres Gonzalez ◽  
Kaihan Fakhar ◽  
David Gubernick ◽  
Sonal Tuli
Keyword(s):  
Antibiotic Sensitivity ◽  
Visual Outcome ◽  
Nocardia Asteroides ◽  
Filamentous Bacteria ◽  
Sensitivity Testing ◽  
Presumptive Diagnosis ◽  
Good Visual Outcome ◽  
History Of ◽  
Extensive Debridement ◽  
Rule Out

Purpose. To describe a case of postoperative scleritis caused by a novel strain ofNocardiaresistant to linezolid and trimethoprim-sulfamethoxazole (TMP-SMX).Methods. Case report of a patient with microbiologically proven scleritis due toNocardia asteroides.Results. The patient presented with pain, redness, and nodules on the sclera three months following pterygium excision with mitomycin C and amniotic membrane placement. As no response was noted with empiric treatment for bacterial scleritis, debridement was performed. The cytopathology report showed gram positive filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made and therapy was initiated based on a literature review on treatments forNocardiainfections. Cultures returned growingNocardia asteroides. Antibiotic sensitivity testing revealed resistance to linezolid and TMP-SMX which are the traditional drugs of choice forNocardia. The patient was treated with amikacin and imipenem as well as extensive debridement with pedicle grafts. The patient’s scleritis resolved with a good visual outcome.Conclusions. Cultures should be obtained in all cases of necrotizing scleritis in patients with a recent history of conjunctival surgery to rule out unusual organisms such asNocardia. Although literature states that resistance to linezolid and TMP-SMX is rare inNocardia, sensitivity testing can be useful in unresponsive cases.

scholarly journals Significant hyperopic shift in a patient with extreme myopia following severe hypotonia caused by glaucoma filtering surgery

2018 ◽  
Vol 29 (1) ◽  
pp. NP6-NP9 ◽  
Author(s):  
João C Costa ◽  
Jorge Alió
Keyword(s):  
Intraocular Pressure ◽  
Macular Edema ◽  
Intraocular Lens ◽  
Axial Length ◽  
Length Change ◽  
Filtering Surgery ◽  
Lens Extraction ◽  
History Of ◽  
Severe Hypotonia ◽  
The Right

Introduction: To report the case of a high hyperopic refractive shift associated with significant shortening of the ocular axial length following glaucoma filtering surgery. Methods: Case report. Patient’s records were consulted retrospectively. Results: A 57-year-old woman, highly myopic, with a history of bilateral intraocular refractive surgery in 1998 (phakic lens ZB5M) and bilensectomy in 2011 (phakic intraocular lens extraction plus cataract surgery with pseudophakic intraocular lens implantation), presented with consistently high intraocular pressure. Despite the treatment with different topical antiglaucomatous medications and good compliance, her intraocular pressure values remained consistently above 20 mmHg. In 2016, the patient was submitted for glaucoma filtering surgery and the mini shunt Ex-Press was implanted in both the eyes (3 months between surgeries). On the first postoperative day, the eyes were hypotonic (intraocular pressure of 5 mmHg) and bilateral macular edema was observed. Three days later, the intraocular pressure in both the eyes reached values higher than 6 mmHg (between 6 and 14 mmHg). Five months after the surgery the macular edema resolved and a significant shortening of the axial length and an important hyperopic refractive shift was observed. When comparing the preoperative and postoperative (18 months) measurements, the variation of the axial length was 2.49 mm in the right eye and 2.19 mm in the left eye; the patient refraction (spherical equivalent) shifted 2.50 diopters in the right eye and 1.75 diopters in the left eye. Conclusion: To the best of our knowledge, we report herein the first documented case of an axial length change of this magnitude after glaucoma filtering surgery.

scholarly journals A rare case of unilateral breast filariasis mimicking chronic mastitis

2021 ◽  
Vol 8 (7) ◽  
pp. 2228
Author(s):  
Varsha A. Sharma ◽  
Manmohan M. Kamat ◽  
Jeena K. Sathyan ◽  
Seema Barman ◽  
Shravani Shetye
Keyword(s):  
Benign Lesion ◽  
Rare Condition ◽  
Surgical Excision ◽  
Axillary Lymph Nodes ◽  
Excision Biopsy ◽  
Axillary Lymph ◽  
Presumptive Diagnosis ◽  
Lower Quadrant ◽  
History Of ◽  
The Right

Filariasis of the breast is a very rare condition. In India, largest number (around 600 million) of people live in endemic areas. Despite the huge number, it is quite rare to find microfilaria in routine smears and body fluids and it is even more rare to find it in breasts. A 40 years old female, presented with a history of lump in the right breast approximately 3x3 cm in size in the right lower quadrant. Findings were confirmed by clinical examination which did not reveal any palpable ipsilateral or contralateral axillary lymph nodes. FNAC showed it as a benign lesion. After local excision, histopathology revealed a filarial worm. Filariasis of the breast is a rare disease. The presence of microfilaria in breasts using FNAC has been reported at times but the presence of the filarial worms can only be confirmed on histopathology, hence a core biopsy or an excision biopsy is a must in all the cases. A presumptive diagnosis of filariasis can be made on sonography if the worms are alive and active, the typical presentation on USG is the filarial dance. Surgical excision of the lump followed by DEC therapy is the treatment of choice for filarial lump of the breast.

scholarly journals Rebound Iritis With a Well-circumscribed Anterior Chamber Fibrin Mass After Uncomplicated Cataract Surgery

2021 ◽  
Author(s):  
Nilesh Raval ◽  
Wen-Jeng Yao ◽  
Gene Kim ◽  
Joann J. Kang
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Medication Compliance ◽  
Topical Steroid ◽  
Fibrin Clot ◽  
Posterior Chamber ◽  
Posterior Chamber Intraocular Lens ◽  
History Of ◽  
The Right

Abstract Purpose: To describe a case of bilateral rebound iritis complicated by a subacute, transient, well-circumscribed anterior chamber mass.Methods and Observations: Observational case report of a 59-year-old female with recent ocular history of bilateral cataract surgery and poor post-operative medication compliance who was found to have bilateral rebound iritis and a globular, pedunculated anterior chamber mass attached to the posterior chamber intraocular lens in the right eye. Slit lamp photographs were taken, and after three days of topical steroid administration, the mass resolved with only a mild, residual iritis.Conclusions and Importance: Post-operative fibrinous exudates are occasionally encountered immediately after intraocular surgery, however, there have been no reports in the literature to the best of our knowledge of a subacute anterior chamber mass in such a well-circumscribed configuration as we report. This case study raises awareness of a peculiar structural form in which a subacute, post-operative fibrin clot may present.

scholarly journals Successful Technique for Closure of Macular Hole Retinal Detachment Using Autologous Retinal Transplant

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Juan Abel Ramirez-Estudillo ◽  
Geovanni Rios-Nequis ◽  
Martin Jimenez-Rodríguez ◽  
Hugo Valdez-Flores ◽  
Ximena Ramirez-Galicia
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Donor Site ◽  
Surgical Methods ◽  
Macular Hole Retinal Detachment ◽  
History Of ◽  
Dye Staining ◽  
Pars Plana ◽  
Sudden Decrease ◽  
The Right

Macular hole retinal detachment (MHRD) for the most part develops in highly myopic eyes. Several surgical methods have been introduced to treat MHRD. We describe our experience with the autologous retinal transplant in patient with MHRD. A 49-year-old female presented with a 2-week history of a sudden decrease in the central vision in the right eye (RE). A 3-port, 25-gauge pars plana vitrectomy was performed with the ILM dye staining and peeling. Endodiathermy was applied around a 1.5-disc diameter neurosensory donor site in the supertemporal retina. The graft was cut with standard 25-gauge curved scissors. Perfluoro-n-octane (PFO) was instilled. The free graft was gently handled until its packing into the macular hole. Two months following the initial PPV, the macular hole was closed, and vision improved from 0.05 to 0.25 logMAR.

scholarly journals Combined Astigmatic Arcuate Keratotomy with Descemet Automated Endothelial Keratoplasty

2021 ◽  
pp. 640-645
Author(s):  
Jacques Bijon ◽  
Myrsini Petrelli ◽  
Basile Salmon ◽  
Kattayoon Hashemi ◽  
George D. Kymionis
Keyword(s):  
Cataract Extraction ◽  
Posterior Chamber ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Corneal Incision ◽  
Corrected Visual Acuity ◽  
Effective Combination ◽  
History Of ◽  
One Year ◽  
Posterior Chamber Iol

We report the results of simultaneous astigmatic arcuate keratotomy (AK) and Descemet automated endothelial keratoplasty (DSAEK). A 55-year-old patient with a history of high myopia was referred for the management of bullous keratopathy secondary to an anterior chamber phakic intraocular lens (pIOL). IOL explantation through a 5.5-mm corneal incision, cataract extraction, and posterior chamber IOL implantation, combined with DSAEK, were performed. Postoperatively, increased astigmatism up to 2.0 diopters (Dpt) was observed, attributed to the large corneal incision, and remained stable, despite suture removal at 3 months. One year postoperatively, the graft showed signs of progressive endothelial dysfunction. A combined procedure of astigmatic AK and DSAEK was thus performed. After 6 months, topographic astigmatism was significantly reduced to 0.5 Dpt and best-corrected visual acuity increased. In conclusion, simultaneous astigmatic AK and DSAEK could be an effective combination for treating patients with well-documented pre-existing astigmatism and endothelial decompensation.

scholarly journals A Rare Case of Anti Phospholipid Syndrome Associated Intermediate and Posterior Uveitis

2021 ◽  
pp. 28-33
Author(s):  
Y. Ksheeraja ◽  
N. T. Manasaveena
Keyword(s):  
Anterior Segment ◽  
Posterior Uveitis ◽  
Immunoglobulin M ◽  
Topical Steroids ◽  
Antiphospholipid Antibody ◽  
Multisystem Disorder ◽  
Oral Steroids ◽  
History Of ◽  
The Right ◽  
Anti Phospholipid Syndrome

Introduction: Autoimmune disorders are often associated with Uveitis. Anti-Phospholipid syndrome(APS) is characterized by increased hypercoagulability and divergent ocular features. Case Presentation: A 45-year-old male patient presented with complaints of headache for 2 days. The patient gives a history of fever and loss of consciousness 20 days back and was treated symptomatically. On examination Visual acuity was 6/6 in the right eye and 6/12 in the left eye. On slit-lamp examination, the anterior segment was normal, vitreous cells were 2+ suggestive of vitritis in the left eye. Dilated fundus examination showed exudates in both eyes with macular parafoveal edema in the left eye. Laboratory investigations showed Antiphospholipid Antibody Immunoglobulin M (IgM) and Beta 2 glycoprotein IgM positive and raised ESR, PTT, and triglycerides. MRI brain showed acute embolic infarcts in multiple areas. Management: Topical Steroids and cycloplegic for uveitis and systemic steroids and anticoagulants for systemic manifestations were given and the patient's vision improved to 6/6 and macular edema reduced in the left eye during the follow-up. Conclusion: APS is a life and vision-threatening multisystem disorder, needs monitoring for INR and Anti phospholipid antibodies. A rare manifestation of uveitis is noted and prompt treatment with topical, oral steroids resolves the uveitis. But to prevent recurrences and further thrombotic events long-term immunosuppression, anticoagulation treatment is required.

scholarly journals A Case of Adult Filipino Male Presenting with Co-localized Psoriasis and Segmental Vitiligo

2019 ◽  
Vol 53 (4) ◽  
Author(s):  
Shahara Abalos-Babaran ◽  
Ma. Lorna F. Frez
Keyword(s):  
Rare Case ◽  
Ultraviolet B ◽  
Topical Steroids ◽  
History Of ◽  
Skin Biopsies ◽  
The Right ◽  
Psoriatic Lesions

A 29-year-old male presented with a four-year history of recurrent generalized pruritic erythematous scaly annular plaques followed by a solitary depigmented patch on the right hemiabdomen extending to the back with abrupt midline demarcation. Skin biopsies confirmed the rare case of co-existing and colocalized psoriasis and segmental vitiligo. Treatment with topical steroids, tacrolimus, and narrowband ultraviolet B phototherapy resulted to the improvement of the psoriatic lesions but no change in the depigmented patch.

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