A case series with literature review on adjunctive usage of intravitreal ceftazidime in ocular syphilis with human immunodeficiency virus infection

2021 ◽  
pp. 095646242110119
Author(s):  
Yi Wen Lim ◽  
Pooi Wah Lott ◽  
Nor Fadhilah Mohamad ◽  
Tajunisah Begam Iqbal
Keyword(s):  
Treatment Response ◽  
Transmitted Disease ◽  
Case Series ◽  
Sexually Transmitted ◽  
Ocular Syphilis ◽  
Prompt Treatment ◽  
Immunodeficiency Virus ◽  
Control And Prevention ◽  
Syphilis Treatment ◽  
Injection Methods

Background: Penicillin is the conventional treatment for all stages of syphilis, including ocular and neurosyphilis, according to the recommendations by the Centre for Disease Control and Prevention Sexually Transmitted Disease. This case series highlighted three cases of ocular syphilis which showed prompt treatment response as early as 24 h after the adjunctive intravitreal ceftazidime injection. Methods: Case Series. Results: In case 1, there was significant improvement in the vision and vitritis after 24 h of a single intravitreal ceftazidime injection. In case 2, the patient achieved his best vision after a total of three intravitreal injections in his left eye and one in his right eye. In case 3, there was a further resolution of perivascular sheathing and retinal haemorrhages seen 1 week after a single intravitreal ceftazidime injection. Conclusion: The efficacy of intravitreal ceftazidime injection as a local adjunctive therapy in ocular syphilis treatment is noteworthy. It can be considered in cases which show suboptimal or slower treatment response despite early commencement of systemic penicillin to prevent devastating ocular sequelae.

scholarly journals Disseminated Gonococcal Infections in Patients Receiving Eculizumab: A Case Series

2018 ◽  
Vol 69 (4) ◽  
pp. 596-600 ◽  
Author(s):  
Page E Crew ◽  
Winston E Abara ◽  
Lynda McCulley ◽  
Peter E Waldron ◽  
Robert D Kirkcaldy ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Medical Literature ◽  
Treatment Guidelines ◽  
Antimicrobial Prophylaxis ◽  
Case Series ◽  
The United States ◽  
Underlying Disease ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Terminal Complement

Abstract Background Gonorrhea is the second most commonly reported notifiable condition in the United States. Infrequently, Neisseria gonorrhoeae can cause disseminated gonococcal infection (DGI). Eculizumab, a monoclonal antibody, inhibits terminal complement activation, which impairs the ability of the immune system to respond effectively to Neisseria infections. This series describes cases of N. gonorrhoeae infection among patients receiving eculizumab. Methods Pre- and postmarketing safety reports of N. gonorrhoeae infection in patients receiving eculizumab worldwide were obtained from US Food and Drug Administration safety databases and the medical literature, including reports from the start of pivotal clinical trials in 2004 through 31 December 2017. Included patients had at least 1 eculizumab dose within the 3 months prior to N. gonorrhoeae infection. Results Nine cases of N. gonorrhoeae infection were identified; 8 were classified as disseminated (89%). Of the disseminated cases, 8 patients required hospitalization, 7 had positive blood cultures, and 2 required vasopressor support. One patient required mechanical ventilation. Neisseria gonorrhoeae may have contributed to complications prior to death in 1 patient; however, the fatality was attributed to underlying disease per the reporter. Conclusions Patients receiving eculizumab may be at higher risk for DGI than the general population. Prescribers are encouraged to educate patients receiving eculizumab on their risk for serious gonococcal infections and perform screening for sexually transmitted diseases (STDs) per the Centers for Disease Control and Prevention STD treatment guidelines or in suspected cases. If antimicrobial prophylaxis is used during eculizumab therapy, prescribers should consider trends in gonococcal antimicrobial susceptibility due to emerging resistance concerns.

scholarly journals 945. Prevalence of HIV Associated Non-AIDS Conditions and Associated Risk Factors among Hospitalized HIV-infected Patients in India

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S504-S505
Author(s):  
Amyeo A Jereen ◽  
Celia Kucera ◽  
Saniya Pervin ◽  
Muralidhar Varma ◽  
Radhakrishnan Rajesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transmitted Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Patient Risk ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Artery Disease ◽  
Associated Risk Factors

Abstract Background HIV-associated non-AIDS (HANA) conditions are becoming common as People Living with Human Immunodeficiency Virus (PLWHIV) age. However, data estimating the prevalence of HANA conditions and associated risk factors is lacking in developing countries. This study evaluates reasons for hospitalizations among PLWHIV in Udupi, India in the antiretroviral era, and describes associated risk factors. Methods Demographic and clinical data were extracted from medical charts of 1280 HIV-infected patients 18 years and older who were admitted to Kasturba Hospital, Manipal, India between January 1, 2013 and December 31, 2017, for a total of 2157 hospitalizations. Primary reasons for hospitalization were categorized into AIDS-defining vs Non-AIDS-defining and HANA vs Non-HANA conditions (Fig 1). Multivariate logistic regression analysis was performed to estimate demographic and clinical factors associated with hospitalizations due to AIDS-defining illness and HANA conditions. Categorization of Reasons for Hospitalization Results Patients’ median age was 45 (18-80) years; 70% male. Median age of patients with AIDS-defining illness (45% of hospitalizations) was lower at 44 (18-75) years compared with HANA (15% of hospitalizations) at 48 (21-80) years. Age (OR, 95% CI) (0.985, 0.974-0.995), admission CD4 (0.998, 0.997 - 0.998), history of hypertension (HTN) (0.59, 0.42-0.82), stroke (0.49, 0.24 - 0.93), diabetes (1.56, 1.10 - 2.19), and AIDS-defining cancers (1.74, 1.05 - 2.89) were associated with AIDS-defining hospitalizations (Fig 2). Additionally, age (1.016, 1.001 - 1.031), history of HTN (1.70, 1.16 - 2.46), coronary artery disease (CAD) (4.02, 1.87- 9.02), chronic kidney disease (CKD) (2.30, 1.15 - 4.61), stroke (2.93, 1.46 - 5.96), Hepatitis B (3.32, 1.66- 6.72), Hepatitis C (16.1, 2.84 - 314), sexually transmitted disease (STD) (3.76, 1.38- 10.8), and HANA-associated cancer (2.44, 1.28- 6.42) were associated with HANA hospitalizations (Fig 3). Patient Risk Factors for AIDS-related Hospitalization Patient Risk Factors for HANA-related Hospitalization Conclusion Prevalence of HANA conditions was lower than AIDS-defining illnesses possibly because of a younger population. Patients with AIDS-defining illnesses were also likely to have HANA conditions. Early detection and effective treatment of both HIV and HANA conditions is essential to decrease hospitalizations in low-resource settings. Disclosures All Authors: No reported disclosures

scholarly journals Dynamics of Neisseria gonorrhoeae Attachment: Microcolony Development, Cortical Plaque Formation, and Cytoprotection

2007 ◽  
Vol 75 (10) ◽  
pp. 4743-4753 ◽  
Author(s):  
Dustin L. Higashi ◽  
Shaun W. Lee ◽  
Aurelie Snyder ◽  
Nathan J. Weyand ◽  
Antony Bakke ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Transmitted Disease ◽  
Virus Transmission ◽  
Twitching Motility ◽  
Sexually Transmitted ◽  
Type Iv ◽  
Immunodeficiency Virus ◽  
Live Cell Microscopy ◽  
Induced Apoptosis ◽  
First Time

ABSTRACT Neisseria gonorrhoeae is the bacterium that causes gonorrhea, a major sexually transmitted disease and a significant cofactor for human immunodeficiency virus transmission. The retactile N. gonorrhoeae type IV pilus (Tfp) mediates twitching motility and attachment. Using live-cell microscopy, we reveal for the first time the dynamics of twitching motility by N. gonorrhoeae in its natural environment, human epithelial cells. Bacteria aggregate into microcolonies on the cell surface and induce a massive remodeling of the microvillus architecture. Surprisingly, the microcolonies are motile, and they fuse to form progressively larger structures that undergo rapid reorganization, suggesting that bacteria communicate with each other during infection. As reported, actin plaques form beneath microcolonies. Here, we show that cortical plaques comigrate with motile microcolonies. These activities are dependent on pilT, the Tfp retraction locus. Cultures infected with a pilT mutant have significantly higher numbers of apoptotic cells than cultures infected with the wild-type strain. Inducing pilT expression with isopropyl-β-d-thiogalactopyranoside partially rescues cells from infection-induced apoptosis, demonstrating that Tfp retraction is intrinsically cytoprotective for the host. Tfp-mediated attachment is therefore a continuum of microcolony motility and force stimulation of host cell signaling, leading to a cytoprotective effect.

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