Bilateral fungal infection inducing a serpiginous-like picture

2020 ◽  
pp. 112067212090872
Author(s):  
Alvaro Fernández-Vega González ◽  
Carlos Fernández-Vega González ◽  
Beatriz Fernández-Vega Sanz ◽  
María Teresa Peláez ◽  
Jesús Merayo-Lloves
Keyword(s):  
Visual Acuity ◽  
Fungal Infection ◽  
Inflammatory Diseases ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Blood Analysis ◽  
Retinal Pigmented Epithelium ◽  
Pigmented Epithelium ◽  
Laboratory Investigations ◽  
The Right

Purpose: To report the clinical findings of a patient who presented with an atypical bilateral fungal retinitis that was established by retinochoroidal biopsy. Methods: Case report. Results: A 56-year-old systemically healthy man presented with progressive visual loss in his left eye for 3 weeks. Visual acuity was 20/40 in the left eye, and 20/20 in the right eye and fundus examination showed macular retinal pigmented epithelium changes in his left eye. Over the following four months, his lesions progressed to serpiginous-like widespread retinal pigmented epithelium atrophy and his visual acuity decreased to 20/100, but no signs of ocular inflammation were found. Treatment with oral corticoids, valganciclovir and trimethoprim/sulfamethoxazole showed no efficacy. Blood analysis and cultures, laboratory investigations, and imaging tests were carried out looking for infectious and inflammatory diseases, but all tests were negative. Two months later, the patient presented with the same kind of lesions in the other eye (right eye), so he was subjected to retinochoroidal biopsy. Histopathological examination of specimen revealed the presence of intraretinal and choroidal fungal hyphae. Oral voriconazole was initiated achieving clinical remission, but no visual improvement was obtained. The source of the infection remains unknown since all tests results were negative. However, his profession as brewmaster might be related to the origin of the infection. Conclusion: Diagnosis of intraocular fungal infection can be challenging. Retinochoroidal biopsy may be useful to establish the diagnosis in those atypical cases with nonrevealing workup and inflammation localized to the retina.

scholarly journals Cardiac tamponade secondary to hemorrhagic pericardial effiision in five dogs

2017 ◽  
Vol 56 (1) ◽  
pp. 9
Author(s):  
C. G. HATZIGIANNAKIS (Χ.Γ. ΧΑΤΖΗΓΙΑΝΝΑΚΗΣ) ◽  
M. E. MYLONAKIS (Μ. Ε. ΜΥΛΩΝΑΚΗΣ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ) ◽  
M. PATSIKAS (Μ. ΠΑΤΣΙΚΑΣ) ◽  
D. PSALLA (Δ. ΨΑΛΛΑ) ◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Pericardial Fluid ◽  
Exercise Intolerance ◽  
Right Atrial ◽  
Atrial Wall ◽  
History Of ◽  
Cardiac Silhouette ◽  
The Right

A 7-year old female collie (case 1), a 3-year old male Caucasian-cross (case 2) and three male German shepherds with an age of 11 (case 3), 8.5 (case 4) and 10 (case 5) years, respectively, were admitted with a history of decreased appetite, depression, exercise intolerance, dyspnea and progressive abdominal enlargement, for the last 10 to 60 days. Poor body condition (5/5), muffled heart sounds (5/5), weak femoral pulse (5/5), ascites (5/5), inspiratory or inspiratory-expiratory dyspnea (5/5), pulsus paradoxus (2/5) and jugular vein distension (2/5) were the prominent clinical findings, while mature neutrophilic leukocytosis (3/5), lymphopenia (3/5), eosinopenia (3/5), hypoproteinemia (5/5) and increased urea nitrogen (3/5) were the most prevalent clinicopathologic abnormalities. Apart from a space-occupying lesion onto the right atrial wall of one dog (case 4), radiographic and ultrasound examination showed a globe-shaped cardiac silhouette (5/5), pericardial effusion (5/5), ascites (5/5) and pleural effusion (4/5). A large amount of non-clotting hemorrhagic effusion was drained during pericardiocentesis, resulting in rapid clinical recovery. Physical, chemical and cytological evaluation of the pericardial fluid was non-contributory in the differentiation between neoplastic and non-neoplastic causes of these effusions. Case 3 died 25 days post-pericardiocentesis; right atrium hemangiosarcoma and pulmonary metastases were documented on post mortem histopathological examination. Another dog (case 5) died of unknown causes one month after pericardiocentensis. On the contrary, dogs 1, 2 and 4 were still clinically healthy for a followup period of 16, 2 and 8 months, respectively.

scholarly journals Neovessel as first manifestation of relapse of associated multifocal choroiditis and MEWDS

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Eduardo Morizot ◽  
Camila Schiavo Froner
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Inflammatory Diseases ◽  
Clinical Findings ◽  
Optical Coherence ◽  
Retrospective Case ◽  
Multifocal Choroiditis ◽  
White Dot Syndrome ◽  
Contralateral Eye ◽  
The Right

Abstract Purpose To report a case of multifocal choroiditis (MC) that has relapsed as choroidal neovascularization in the contralateral eye followed by a mixed aspect of multiple evanescent white dot syndrome (MEWDS) and MC. Methods Retrospective case report and literature review. The clinical findings were documented by fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography (OCT-A). Results The authors describe the case of a 39-year-old woman with prior ocular history of presumed MEWDS in her left eye, which developed into MC 7 years later in the same eye and 11 years later in the right eye, starting as choroidal neovascularization and developing into MEWDS. OCT-A showed neovessel in a supposedly active MC area outside the macular region in right and left eyes. OCT showed increased choroidal thickness in both eyes and a choroidal neovascularization in the right eye, treated using anti- VEGF therapy. Conclusion This case corroborates the proximity of some inflammatory diseases such as MC and MEWDS. OCT-A has opened new horizons for the better understanding of some retinal diseases by providing more thorough and promising morphological analyses using enhanced tools.

scholarly journals Submacular Cysticercosis Successfully Treated through Conservative Management: Case Report

2020 ◽  
Vol 11 (2) ◽  
pp. 315-321
Author(s):  
Renata García Franco ◽  
Alejandro Arias Gómez ◽  
Juvenal Guzman Cerda ◽  
Marlon García Roa ◽  
Paulina Ramirez Neria
Keyword(s):  
Visual Acuity ◽  
Medical Management ◽  
Central Nervous System Involvement ◽  
Vitreoretinal Surgery ◽  
Visual Outcome ◽  
Clinical Findings ◽  
Ophthalmological Examination ◽  
Blurred Vision ◽  
Elevated Lesion ◽  
The Right

Appropriate medical management can be an alternative in those patients with submacular cysticercosis in whom achieving good visual outcome with vitreoretinal surgery is not possible. We report the case of a 25-year-old female who presented complaining of blurred vision in her left eye associated with photopsias and metamorphopsias of 3 months duration. Initial visual acuity in the right eye was 20/20 and 20/100 in the left eye. Upon indirect ophthalmoscopy in the left eye, a yellow-white, dome-shaped, elevated lesion with foveal involvement was observed. The rest of the ophthalmological examination proved normal. With clinical findings and images, submacular cysticercosis was diagnosed, and vitreoretinal surgery was suggested. Nevertheless, the patient did not accept the treatment; therefore, medical management was initiated. Central nervous system involvement was ruled out, and treatment with praziquantel and systemic prednisolone was initiated. Cysticercosis was resolved with significant improvement of her symptoms and visual acuity.

scholarly journals Macular Retinoschisis and Its Semiotic Importance: A Case Report

2015 ◽  
Vol 69 (1) ◽  
pp. 40-44
Author(s):  
Milena Golubovic ◽  
Bekim Tatesi ◽  
Igor Isjanovski ◽  
Karolina Buzarovska
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Disease Transmission ◽  
Correct Diagnosis ◽  
Diagnostic Methods ◽  
Hereditary Diseases ◽  
Macular Retinoschisis ◽  
Pigmented Epithelium ◽  
Vitreoretinal Degeneration ◽  
The Right

Abstract Introduction. The concept of retinoschisis means splitting of the layers of neural retina. It can happen equally at the peripheral part of retina, as well as in the region of macula when we talk about macular retinoschisis. Macular retinoschisis appears as one of the characteristics of a few hereditary diseases. According to the ophthalmoscopes’ picture it can easily be mixed with cystoid macular edema. Even though macular changes, in both cases, during time lead to decrease of visual acuity, distinction of macular changes is of semiotic significance in differential diagnosis of retinal diseases, which is important from a broader medical aspect. The aim of this paper is, by presenting a case with a rare hereditary disorder, to show the importance and complementarities of diagnostic methods, especially OCT and its meaning in establishing the correct diagnosis. Case report. The paper presents a patient with macular retinoschisis, as a part of Goldmann-Favre vitreoretinal degeneration. It is a hereditary disorder, which in addition to schisms changes in the macula is characterized by changes in the pigmented epithelium at the medial part of retina. OCT finding in our patient showed cystic hyporeflexive change in the fovea, with palisade oriented smaller hyporeflexive changes, between plexiform layers and in the inner granular layer of the macula. On fluorescein angiography the leakage of the fluorescein in the macular region was absent, but the changes on the level of pigmented epithelium in the area of medial retina were evident. However, perimetry did not show defect in the visual field. Conclusion. Newer diagnostic methods, such as optical coherence tomography, proved their importance in the decision making process and in making the right diagnosis in macular lesions. Beside the fact that the correct diagnosis of the disorder frequently has no importance in the sense of therapeutic possibility of the disease, its value can be seen in proper information of possibility of disease transmission as well as in prediction of affected person’s life perspective, associated with the decrease of visual acuity.

scholarly journals LETTER TO THE EDITOR Excision of Congenital Bilateral Persistent Pupillary Membrane in a Child with Exotropia

2015 ◽  
Vol 9 (1) ◽  
pp. 33-35
Author(s):  
Michiko Iida ◽  
Tatsuya Mimura ◽  
Mari Goto ◽  
Yuko Kamei ◽  
Aki Kondo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Surgical Treatment ◽  
Histopathological Examination ◽  
Crystalline Lens ◽  
Ocular Tissues ◽  
Corrected Visual Acuity ◽  
The Right ◽  
Best Corrected Visual Acuity ◽  
High Hyperopia

Purpose : To report the clinical and histopathological findings of a patient who had bilateral persistent pupillary membrane with exotropia and high hyperopia. Methods : Case Report: A 7-year-old boy presented with a persistent pupillary membrane in both eyes. His best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/32 in the left eye with exotropia of 18 prism diopters. He underwent surgical resection of both membranes. At 5 months postoperatively, BCVA was 20/20 with final bilateral refraction of +6.5 D in both eyes. Exotropia and photophobia showed improvement immediately after surgery. Histopathological examination revealed typical features of normal iris tissue in the excised membranes. Conclusion : Bilateral persistent pupillary membranes were excised successfully without injury to other ocular tissues, including the crystalline lens. Surgical treatment may be required for the management of persistent pupillary membrane associated with visual impairment such as exotropia or photophobia.

scholarly journals SUBCUTANEOUS PHEOHYPHOMYCOSIS CAUSED BY Phoma cava: REPORT OF A CASE AND REVIEW OF THE LITERATURE

1997 ◽  
Vol 39 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Clarisse ZAITZ ◽  
Elisabeth Maria HEINS-VACCARI ◽  
Roseli Santos de FREITAS ◽  
Giovana Letícia Hernández ARRIAGADA ◽  
Ligia RUIZ ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Male Patient ◽  
Histopathological Examination ◽  
Corticosteroid Treatment ◽  
Skin Lesions ◽  
Pulmonary Sarcoidosis ◽  
Review Of The Literature ◽  
Right Hand ◽  
The Right

We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B, followed by itraconazole

scholarly journals Pre-operative diagnosis of ovarian ectopic pregnancy: a challenge to practicing clinician

2019 ◽  
Vol 8 (3) ◽  
pp. 1193
Author(s):  
Shalini Mahana Valecha ◽  
Dolly Bashani ◽  
Jaya Gedam ◽  
Pandeeswari .
Keyword(s):  
Ectopic Pregnancy ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Uneventful Recovery ◽  
Ultrasound Scan ◽  
First Case ◽  
Stromal Tissue ◽  
Ectopic Pregnancies ◽  
The Right ◽  
Medical Advances

The first case of primary ovarian ectopic pregnancy was reported by St. Maurice in 1689. Primary ovarian ectopic pregnancy is rare entity, with incidence of around 3% of all ectopic pregnancies. The aim of present case report is to study the role of different modalities like clinical findings, biochemistry, sonography, surgery and histopathology in diagnosis of primary ovarian ectopic pregnancy. Authors present a case of a 24 years old female with history of 2 months amenorrhoea, per vaginal spotting and mild intermittent abdominal pain in RIF. Examination was unremarkable and serum βHCG was 2007.5IU/ml. An ultrasound scan showed an ectopic mass in the right adnexa suggestive of a tubal ectopic pregnancy and she underwent surgical management at our institute.  At laparoscopy, both fallopian tubes were noted to be normal with an ectopic mass attached to the right ovary with a pedicle. With these unusual laparoscopic findings, possibilities of tubal miscarriage, ovarian pregnancy, or abdominal pregnancy were suspected. Ectopic mass was coagulated and cut through the pedicle with bipolar cautery and specimen was sent for HPE. Our patient made an uneventful recovery and no further medical management was indicated. The diagnosis of right ovarian ectopic pregnancy was finally confirmed by histopathological evidence of the presence of chorionic villi in a background of ovarian stromal tissue, in consideration with Spigelberg’s criteria. Present case highlights the importance of considering non-tubal ectopic pregnancies when making a diagnosis based on ultrasound scan. Pre-operative diagnosis of ovarian ectopic pregnancy still remains a challenge in spite of current medical advances. Despite the benefits and reliability of ultrasound scanning, there will still be situations where the definitive diagnosis can only be made at surgery. However, histopathological examination is confirmatory and always mandatory.

scholarly journals Acute Zonal Occult Outer Retinopathy with Atypical Findings

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Dimitrios Karagiannis ◽  
Georgios A. Kontadakis ◽  
Artemios S. Kandarakis ◽  
Nikolaos Markomichelakis ◽  
Ilias Georgalas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Clinical Symptoms ◽  
Clinical Findings ◽  
Case Presentation ◽  
Full Field ◽  
Normal Limits ◽  
Corrected Distance Visual Acuity ◽  
Light Rise ◽  
The Right

Background. To report a case of acute zonal occult outer retinopathy (AZOOR) with atypical electrophysiology findings.Case Presentation. A 23-year-old-female presented with visual acuity deterioration in her right eye accompanied by photopsia bilaterally. Corrected distance visual acuity at presentation was 20/50 in the right eye and 20/20 in the left eye. Fundus examination was unremarkable. Visual field (VF) testing revealed a large scotoma. Pattern and full-field electroretinograms (PERG and ERG) revealed macular involvement associated with generalized retinal dysfunction. Electrooculogram (EOG) light rise and the Arden ratio were within normal limits bilaterally. The patient was diagnosed with AZOOR due to clinical findings, visual field defect, and ERG findings.Conclusion. This is a case of AZOOR with characteristic VF defects and clinical symptoms presenting with atypical EOG findings.

scholarly journals Clinical Findings of Melanoma-Associated Retinopathy with anti-TRPM1 Antibody

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yoichiro Shinohara ◽  
Ryo Mukai ◽  
Shinji Ueno ◽  
Hideo Akiyama
Keyword(s):  
Visual Acuity ◽  
Transient Receptor Potential ◽  
Vision Loss ◽  
Receptor Potential ◽  
Clinical Findings ◽  
Cystic Changes ◽  
History Of ◽  
Interdigitation Zone ◽  
Transient Receptor ◽  
The Right

Introduction. We report the clinical features and clinical course of melanoma-associated retinopathy (MAR), in which autoantibodies against the transient receptor potential cation channel subfamily M member 1 (TRPM1) were detected. Case Presentation. A 74-year-old man was referred to our hospital for treatment of bilateral vision loss. The best-corrected visual acuity was 20/100 in the right eye and 20/200 in the left eye. His electroretinogram (ERG) showed a reduced b-wave and a normal dark-adapted a-wave in both eyes. Optical coherence tomography (OCT) revealed loss of the interdigitation zone in both eyes. We strongly suspected MAR based on the markedly reduced b-wave in the ERG and a history of intranasal melanoma. The diagnosis was confirmed after autoantibodies against TRPM1 were detected in his blood serum. Fifteen months later, his ERG remained unchanged, and OCT showed bilateral cystic changes in the internal nuclear layer. The visual acuity in both eyes also remained unchanged. Conclusions. Anti-TRPM1 autoantibodies were detected in a patient diagnosed with MAR who had negative flash ERG and retinal microstructural abnormalities, and the impairment did not recover during the follow-up period. Identification of anti-TRPM1 antibodies was helpful in confirming the diagnosis of MAR.

Immune keratitis: An unusual primary presentation of neuro-Behçet’s disease

2018 ◽  
Vol 29 (4) ◽  
pp. NP5-NP8
Author(s):  
Jitender Jinagal ◽  
Aniruddha Agarwal ◽  
Avinash Negi ◽  
Gaurav Gupta ◽  
Vikas Sharma ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Disease Patient ◽  
Behcet's Disease ◽  
Ocular Discomfort ◽  
Laboratory Investigations ◽  
Systemic Examination ◽  
The Right

A 19-year-old Nepalese male presented with complaints of bilateral ocular discomfort, photophobia, watering, and redness for 1 week. Visual acuity was 6/12 and 6/60 in the right and left eye, respectively. On biomicroscopic examination, presence of peripheral stromal infiltrates with conjunctival follicles was noted; infiltrates progressed to involve central cornea with further decrease in vision over next few days. After ruling out infectious keratitis, detailed systemic examination and laboratory investigations were diagnostic of neuro-Behçet’s disease. Patient responded to systemic steroidal and immunosuppressive therapy characterized by corneal healing and visual acuity improvement to 6/6 and 6/9. Although rare, but neuro-Behçet’s disease can primarily present as bilateral immune keratitis and every case of bilateral keratitis needs early systemic evaluation after ruling out infective etiologies.

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