Ocular Toxocariasis Presenting as Endophthalmitis in a Young Adult Intravenous Drug User

2020 ◽  
pp. 247412642094658
Author(s):  
Pali P. Singh ◽  
Cason B. Robbins ◽  
Henry L. Feng ◽  
Durga S. Borkar ◽  
Sharon Fekrat
Keyword(s):  
Drug User ◽  
Intravenous Drug User ◽  
Toxocara Canis ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Ocular Toxocariasis ◽  
Fundus Imaging ◽  
Common Causes ◽  
History Of ◽  
Optical Coherence Tomography Imaging

Purpose: This report describes the diagnosis of ocular toxocariasis presenting as endophthalmitis in an adult intravenous drug user. Methods: A case is reported. Results: Fundus imaging showed numerous white opacities obscuring the macula. Toxocara canis serology was reactive with an enzyme immunoassay titer of 1:2 (positive ≥ 1:32). Findings from bacterial and fungal cultures were negative, and vitrectomy cytology revealed no organisms. Postoperatively, serial optical coherence tomography imaging demonstrated a slight decrease in size of an intraretinal hyperreflective lesion in the macula. Conclusions: Owing to a variety of presentations, ocular toxocariasis can be challenging to diagnose. In a patient with a history of intravenous drug use where fungal and bacterial organisms are more common causes of endophthalmitis, it is important to have a wide differential of causative organisms, particularly in the context of negative culture results and a worsening clinical examination.

scholarly journals Burkholderia cepacia complexCervical Osteomyelitis in an Intravenous Drug User

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Sui Kwong Li ◽  
William B. Messer
Keyword(s):  
Drug Use ◽  
Drug User ◽  
Burkholderia Cepacia ◽  
Vertebral Osteomyelitis ◽  
Intravenous Drug User ◽  
Intravenous Drug ◽  
Burkholderia Cepacia Complex ◽  
Minor Trauma ◽  
Anterior Fusion ◽  
Intravenous Drug Use

Gram-negative vertebral osteomyelitis infections are increasing due to rising intravenous drug use but overall remain uncommon. Here, we present a case ofBurkholderia cepacia complexcervical osteomyelitis in an intravenous drug user.Burkholderia cepaciacomplexvertebral osteomyelitis has been infrequently described in the literature thus far with varied antibiotic treatment regimens. A 68-year-old male presented to the emergency department with neck pain after minor trauma. He endorsed active intravenous heroin and methamphetamine use. CT and MRI imaging of the cervical spine revealed destructive changes of C5-C6 vertebral bodies consistent with osteomyelitis. Neurological exam was stable and vital signs were within normal limits; so, antibiotics were held, and he was admitted for diagnostic evaluation. Five sets of blood cultures were drawn on admission and were ultimately negative. He subsequently underwent C5-C6 corpectomy, C4-C7 anterior fusion, and C3-T1 posterior fusion with allograft placement. Deep operative tissue cultures grewBurkholderia cepacia complex. He was treated with 6 weeks of intravenous ceftazidime followed by indefinite oral minocycline due to hardware placement.Burkholderia cepacia complexshould be considered among pathogenic etiologies of pyogenic vertebral osteomyelitis, particularly among patients with intravenous drug use. Ceftazidime monotherapy was an effective treatment in this particular case.

scholarly journals Mycotic Pulmonary Arterial Aneurysms in an Intravenous Drug User

1998 ◽  
Vol 5 (4) ◽  
pp. 307-311 ◽  
Author(s):  
Laura McLean ◽  
Sat Sharma ◽  
Bruce Maycher
Keyword(s):  
Drug User ◽  
Conservative Therapy ◽  
Clinical Presentation ◽  
Intravenous Drug User ◽  
Artery Aneurysm ◽  
Intravenous Drug ◽  
Pulmonary Artery Aneurysm ◽  
History Of ◽  
Pulmonary Arterial ◽  
Arterial Aneurysms

A case of mycotic pulmonary artery aneurysm (PAA) in an intravenous drug user in whom resolution occurred with conservative therapy is described. The natural history of PAA is not well described in the literature. Although PAA is potentially fatal, resolution may occur in patients who do not have hemoptysis. Clinical presentation, diagnosis and management of PAA are reviewed.

scholarly journals The advantages and limitations of echocardiography in a unique presentation of double-sided endocarditis from intravenous drug use

2016 ◽  
Vol 3 (3) ◽  
pp. 26
Author(s):  
Ben Alencherry ◽  
Claire Sullivan ◽  
Brian Hoit
Keyword(s):  
Infective Endocarditis ◽  
Intravenous Drug User ◽  
Posterior Wall ◽  
Intravenous Drug ◽  
Valvular Regurgitation ◽  
Intravenous Drug Use ◽  
Multiple Organs ◽  
Posterior Mitral Leaflet ◽  
History Of ◽  
Extent Of Disease

A 25-year-old female intravenous drug user presented with a three-week-history of fever and myalgias and was found to have infective endocarditis affecting the mitral and tricuspid valves.  Blood cultures grew methicillin sensitive Staphylococcus aureus. Computed tomography showed emboli in multiple organs.  Transthoracic echocardiogram revealed large vegetations on the mitral valve with moderate valvular regurgitation and a transesophageal echocardiogram identified a posterior mitral leaflet perforation.  The patient underwent urgent surgical intervention after developing respiratory distress from worsening congestive heart failure.  Intraoperative findings in addition to those found on echocardiography included a large abscess in the posterior wall of the left atrium.  The patient underwent mitral and tricuspid valve replacement due to valve damage.  This case shows a unique presentation of valvular involvement of infective endocarditis and the capabilities and limitations of echocardiography in assessing the extent of disease in this condition.

scholarly journals Proteusendocarditis in an intravenous drug user

2015 ◽  
pp. bcr2015212447 ◽  
Author(s):  
Rohan Goel ◽  
Baskar Sekar ◽  
Mark N Payne
Keyword(s):  
Drug User ◽  
Intravenous Drug User ◽  
Intravenous Drug

Nonsurgical cure of isolated cerebral mucormycosis in an intravenous drug user

1996 ◽  
Vol 15 (7) ◽  
pp. 598-599 ◽  
Author(s):  
R. Blázquez ◽  
A. Pinedo ◽  
J. Cosín ◽  
P. Miralles ◽  
C. Lacruz ◽  
...  
Keyword(s):  
Drug User ◽  
Intravenous Drug User ◽  
Intravenous Drug

scholarly journals Adult Ocular Toxocariasis Mimicking Ciliary Body Malignancy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmad M. Mansour ◽  
Bachir Abiad ◽  
Fouad I. Boulos ◽  
Ramzi Alameddine ◽  
Fadi C. Maalouf ◽  
...  
Keyword(s):  
Case Report ◽  
Local Excision ◽  
Rapid Growth ◽  
Ciliary Body ◽  
Inflammatory Cells ◽  
Toxocara Canis ◽  
Unusual Presentation ◽  
Medial Rectus ◽  
Ocular Toxocariasis ◽  
History Of

Purpose. To discuss an unusual presentation of ocular toxocariasis.Methods. Case report.Results. A 40-year-old woman presented with decreased vision in the left eye with a long history of recurrent red eye from uveitis. Eosinophilia and positive ELISA titers forToxocara canisfavored the diagnosis of ocular toxocariasis. Over 3 months, an anterior scleral mass had a rapid growth raising the possibility of medulloepithelioma, which rarely can mimic uveitic syndromes. Surgical plan changed from local excision to enucleation. Histopathology demonstrated a large homogeneous mass of chronic inflammatory cells with inflammation of the overlying thinned out sclera, medial rectus insertion, and limbal cornea. The triad of peripheral granuloma, eosinophilia, and positive blood serology established the diagnosis of ocular toxocariasis.Conclusions. Ocular toxocariasis can mimic ocular malignancy such as medulloepithelioma in adults and rarely presents as an anterior scleral mass.

Pyomyositis Complicating Acute Bacterial Endocarditis in an Intravenous Drug User

2000 ◽  
Vol 342 (21) ◽  
pp. 1614-1615 ◽  
Author(s):  
Tze Shien Lo ◽  
Mary G. Mooers ◽  
Larry J. Wright
Keyword(s):  
Drug User ◽  
Intravenous Drug User ◽  
Bacterial Endocarditis ◽  
Intravenous Drug
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