scholarly journals Identification and molecular characterization of Subramaniula asteroides causing human fungal keratitis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rosario Cultrera ◽  
Riccardo Torelli ◽  
Caterina Sarnicola ◽  
Daniela Segala ◽  
Andrea Mengoli ◽  
...  
Keyword(s):  
Filamentous Fungus ◽  
Corneal Edema ◽  
Antimicrobial Treatment ◽  
Fungal Keratitis ◽  
Diagnostic Methods ◽  
Molecular Methods ◽  
Brown Pigment ◽  
Corneal Perforation ◽  
Clinical Progression ◽  
First Case

Abstract Background Keratitis due to by filamentous fungi are not easy to diagnose thus causing a delay in correct therapy. There are many descriptions of keratitis due to Candida, Fusarium and Aspergillus genera. Subramaniula genus has only recently been reported to cause human infections and there are few descriptions of eye infections due to this filamentous fungus. Diagnosis of fungal keratitis is usually based on microscopic and cultural techniques of samples obtained by corneal swabbing or scraping. Considering the amount of time required to obtain culture results it is wise to use other diagnostic methods, such as molecular analyses. Therapeutic options against these fungi are limited by low tissue penetration in the eye due to ocular barriers. We describe the first case of S. asteroides human keratitis treated with isavuconazole. Case presentation We describe a rare case of fungal keratitis unresponsive to antimicrobial treatment in a 65-year-old male patient without a history of diabetes or immunological diseases. He reported that the onset of symptoms occurred during a long holiday in Cape Verde Island. Initial treatment with topical antibiotics associated to steroids were ineffective, allowing a slow clinical progression of disease to corneal perforation. On admission in our Hospital, slit-lamp examination of the left eye showed conjunctival congestion and hyperemia, a large inferior corneal ulceration with brown pigment, corneal edema, about 3 mm of hypopyon and irido-lenticular synechiae. The slow clinical progression of the disease to corneal perforation and the aspect of the ulcer were consistent with a mycotic etiology. Molecular methods used on fungal colonies isolated by Sabouraud’s dextrose agar cultures allowed the identification of Subramaniula asteroids from corneal scraping. Antimicrobial test showed a good susceptibility of this filamentous fungus to voriconazole and isavuconazole. Moreover, this fungal keratitis was successfully treated with isavuconazole, without side effects, observing a progressive clinical improvement. Conclusions Molecular methods may be useful for the identification of filamentous fungal keratitis on scraping samples thus shortening the time of diagnosis. Systemic therapy by isavuconazole could be useful to treat the filamentous fungal keratitis, reducing the possible adverse effects due to the use of voriconazole by systemic administration.

scholarly journals Bilateral Severe Corneal Ulcer in a Patient with Lung Adenocarcinoma Treated with Gefitinib

2021 ◽  
pp. 288-292
Author(s):  
Fabrizio Gozzi ◽  
Marcello Tiseo ◽  
Francesco Facchinetti ◽  
Stefano Gandolfi ◽  
Pierangela Rubino
Keyword(s):  
Vision Loss ◽  
Corneal Ulcer ◽  
Kinase Inhibitor ◽  
Growth Factor Receptor ◽  
Corneal Edema ◽  
Egfr Inhibitors ◽  
Ocular Infection ◽  
Corneal Perforation ◽  
First Case ◽  
Corneal Damage

We describe the case of Gefitinib-related bilateral corneal perforation. An 86-year-old female patient had bilateral painless and progressive vision loss due to neurotrophic corneal ulcer, following a 2-month treatment with Gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor for metastatic adenocarcinoma of the lung with confirmed EGFR gene mutation. She had no signs of ocular infection, inflammation, or lid problems to account for the development of corneal damage. Neurotrophic ulcer evolved into a frank perforation in one eye and an impending perforation on the other eye. EGFR inhibitors have been associated with dry eye, epithelial erosions, ulcerative keratitis, and corneal edema. However, to the best of our knowledge, this is the first case of bilateral severe corneal ulcer due to Gefitinib. The patient went on to have bilateral corneal graft surgery. This case aims to raise awareness among ophthalmologists and oncologists of the association between EGFR inhibitors, corneal neurotrophic ulcers, and possible evolution in corneal perforation.

Paraneoplastic pemphigus associated with rapidly progressing endophthalmitis caused by Morganella Morganii: A case report

2021 ◽  
pp. 112067212110334
Author(s):  
Abdullah I Almater ◽  
Mohammed M Abusayf ◽  
Saeed Alshahrani ◽  
Abdullah M Alfawaz ◽  
Hind M Alkatan ◽  
...  
Keyword(s):  
Positive Culture ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Corneal Perforation ◽  
Morganella Morganii ◽  
Paraneoplastic Pemphigus ◽  
First Case ◽  
Johnson Syndrome ◽  
Acute Necrotizing ◽  
The Right

Introduction: The ocular presentation of paraneoplastic pemphigus (PNP) has rarely been reported in the literature. In this report, we describe a 61-year-old male presenting with eruptive skin lesions associated with underlying non-Hodgkin’s lymphoma who had rapid progressive corneal perforation with secondary endophthalmitis in the setting of PNP. Case description: A 61-year-old male presented to the emergency department complaining of skin eruption mimicking Stevens–Johnson syndrome, which was later found to be related to PNP. Initially, the patient complained of progressive ocular surface dryness in both eyes. Meanwhile, he developed mild pain in the right eye associated with blurry vision in both eyes and was managed with lubricants and topical antibiotics. A few days later, he was found to have corneal perforation with features suggestive of left endophthalmitis with possible early panophthalmitis. Intravenous antibiotic was administered, and primary evisceration of the left globe was performed. Histopathology revealed acute necrotizing keratitis and endophthalmitis. Vitreous analysis showed numerous gram-negative bacilli and a positive culture of Morganella morganii. The patient continued to be managed with frequent lubrications and punctual plugs in the fellow eye during the follow-up period. Conclusion: We describe the first case of endophthalmitis developing secondary to PNP-induced corneal melting and perforation. Anticipating unusual infectious sequelae in the setting of PNP might be warranted to actively detect and successfully manage dry eye disease before devastating complications develop.

scholarly journals Predictors of Corneal Perforation or Need for Therapeutic Keratoplasty in Severe Fungal Keratitis

2017 ◽  
Vol 135 (9) ◽  
pp. 987 ◽  
Author(s):  
N. Venkatesh Prajna ◽  
Tiruvengada Krishnan ◽  
Revathi Rajaraman ◽  
Sushila Patel ◽  
Ranjeet Shah ◽  
...  
Keyword(s):  
Fungal Keratitis ◽  
Corneal Perforation

scholarly journals First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1046
Author(s):  
Robert Kuthan ◽  
Anna K. Kurowska ◽  
Justyna Izdebska ◽  
Jacek P. Szaflik ◽  
Anna Lutyńska ◽  
...  
Keyword(s):  
Contact Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Ocular Infection ◽  
Corneal Perforation ◽  
Purpureocillium Lilacinum ◽  
First Case ◽  
Pars Plana ◽  
Tof Ms

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS.

scholarly journals ХИРУРГИЯ ЭКССУДАТИВНЫХ ПЕРИКАРДИТОВ

2019 ◽  
pp. 14-19
Author(s):  
Лигоненко А. В.
Keyword(s):  
Pericardial Effusion ◽  
Diagnostic Methods ◽  
Common Disease ◽  
Clinical Progression ◽  
Surgical Interventions ◽  
Pericardial Cavity ◽  
Differential Approach ◽  
Literary Sources ◽  
Choice Of Treatment

In the article are presented modern approaches to diagnostics, etiological search and methods of surgical correction of pericardial effusion (PE) of different etiology. PE being the most common disease of the pericardium, often has a secondary nature. The overview of modern literature data is presented about terminology and classification of PE, the possibility of etiological search for the cause of effusion in the pericardial cavity, the main diagnostic methods, as well as the main tasks and methods of pericardial surgical interventions and its indications. Based on the analysis of literary sources, we can conclude that the consensus on the clinical and nosological structure, effectiveness and necessity of using various tests and interventions, clinical progression, epidemiology, prognosis and the reasons for the unsatisfactory results of treated PE is actually absent. Our analysis indicates the absence of a systematic and differential approach to choice of treatment tactics.

scholarly journals Physics Comes to the Aid of Medicine—Clinically-Relevant Microorganisms through the Eyes of Atomic Force Microscope

Pathogens ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 969
Author(s):  
Mateusz Cieśluk ◽  
Piotr Deptuła ◽  
Ewelina Piktel ◽  
Krzysztof Fiedoruk ◽  
Łukasz Suprewicz ◽  
...  
Keyword(s):  
Mammalian Cells ◽  
Antimicrobial Agents ◽  
Antimicrobial Treatment ◽  
Point Of View ◽  
Diagnostic Methods ◽  
Drug Resistant ◽  
Bacterial Strains ◽  
Force Microscopy ◽  
Atomic Force ◽  
Recent Developments

Despite the hope that was raised with the implementation of antibiotics to the treatment of infections in medical practice, the initial enthusiasm has substantially faded due to increasing drug resistance in pathogenic microorganisms. Therefore, there is a need for novel analytical and diagnostic methods in order to extend our knowledge regarding the mode of action of the conventional and novel antimicrobial agents from a perspective of single microbial cells as well as their communities growing in infected sites, i.e., biofilms. In recent years, atomic force microscopy (AFM) has been mostly used to study different aspects of the pathophysiology of noninfectious conditions with attempts to characterize morphological and rheological properties of tissues, individual mammalian cells as well as their organelles and extracellular matrix, and cells’ mechanical changes upon exposure to different stimuli. At the same time, an ever-growing number of studies have demonstrated AFM as a valuable approach in studying microorganisms in regard to changes in their morphology and nanomechanical properties, e.g., stiffness in response to antimicrobial treatment or interaction with a substrate as well as the mechanisms behind their virulence. This review summarizes recent developments and the authors’ point of view on AFM-based evaluation of microorganisms’ response to applied antimicrobial treatment within a group of selected bacteria, fungi, and viruses. The AFM potential in development of modern diagnostic and therapeutic methods for combating of infections caused by drug-resistant bacterial strains is also discussed.

scholarly journals Study of toxoplasmosis and toxocariasis in patients suffering from ophthalmic disorders using serological and molecular methods

2020 ◽  
Vol 40 (9) ◽  
pp. 2151-2157
Author(s):  
Jasem Saki ◽  
Elham Eskandari ◽  
Mostafa Feghhi
Keyword(s):  
Chronic Phase ◽  
Diagnostic Methods ◽  
Molecular Methods ◽  
Ocular Toxoplasmosis ◽  
Larva Migrans ◽  
Control Group ◽  
Case Group ◽  
Ocular Toxocariasis ◽  
Khuzestan Province ◽  
Significant Difference

Abstract Introduction Toxoplasma gondii is an intracellular protozoan parasite that can cause ocular toxoplasmosis with most complications such as retinal detachment. Toxocara parasite, round worm, found in dogs and cats appears as larva migrans in humans can cause serious ocular complications such as debilitating vision loss.In Khuzestan province, southwest of Iran, T. gondii infection has been reported to be significant but toxocariasis was rare. However, the frequency of ocular toxoplasmosis and toxocariasis has not been studied in this area. The aim of this study was to evaluate the ocular toxoplasmosis and ocular toxocariasis using serological and molecular methods. Method In this case control study, 310 patients were identified by ophthalmologist as ocular toxoplasmosis and then 5 cc of venous blood samples were taken from each of them. Serum samples and buffy coat were prepared and ELISA was used to detect IgG and IgM anti-Toxoplasma antibodies and the molecular PCR was used to detect Toxoplasma DNA parasite in buffy coats. ELISA test was used to detect of IgG anti-Toxocara antibodies. Results Totally, for ocular toxoplasmosis, 130 (41.93%) of 310 patients were positive by ELISA, of them 121 (39%) IgG positive and nine (2.9%) IgM positive were diagnosed. Of 121 cases with IgG+, 119 (98.35%) were diagnosed with high IgG avidity indicating chronic phase of the infection. For ocular toxocariasis evaluation, antibodies against Toxocara were not detected in any of the samples. By PCR molecular method, 11 out of 310 patients (3.54%) had T. gondii DNA in the blood. In control, in total, 21 cases were detected positive by serology method, which showed a significant difference with the results of the case group(P < 0.05).By PCR method, only three cases showed positive which also indicated significant difference with result of case group (3 vs 9) (P < 0.05). In the control group, also no anti-toxocara antibodies were found. Conclusion It can be concluded that T. gondii in Khuzestan province as the etiologic agent of ocular toxoplasmosis and physicians should consider diagnostic methods for identifying the infection when they visit the patients.

scholarly journals Accelerated corneal endothelial cell loss in two patients with granulomatosis with polyangiitis following phacoemulsification

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Hung-Ta Chen ◽  
Kuan-Jen Chen ◽  
Yi-Jen Hsueh ◽  
Yaa-Jyuhn James Meir ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Cataract Surgery ◽  
Granulomatosis With Polyangiitis ◽  
Corneal Edema ◽  
Cell Loss ◽  
Multiple Organs ◽  
First Case ◽  
Before And After ◽  
The Right

Abstract Background Generally, the loss rate of human endothelial cells (HCEC) in routine cataract surgery is 8.5%. When the corneal endothelial cells density (ECD) drops, the HCEC may decompensate to keep cornea dehydration which leads to corneal edema. Granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disease involving multiple organs including eyes such as conjunctivitis, scleritis, uveitis, and corneal ulcer. In this study, we report two cases of GPA whose corneal ECD decreased significantly after phacoemulsification cataract surgery. Case presentation In the first case of 69-year-old male with GPA, the ECD dropped 39.6% (OD) four months after phacoemulsification and 38.1% (OS) six months postoperatively respectively. At the final follow-up, the residual ECD was only 55% in the right eye in the 49th month, and 56% remained in the left eye in the 39th month. In the second case of 54-year old female, left ECD dropped 63.9% at the 4th month after surgery and 69.6% ECD remained at the 15th month postoperatively while similar ECD of right eye before and after left eye surgery. Conclusion Extensive preoperative ophthalmic evaluation and meticulous postoperative inflammation control should be applied to prevent severe loss of HCEC in GPA patients.

scholarly journals Hypervirulent Streptococcus agalactiae septicemia in twin ex-premature infants transmitted by breast milk: report of source detection and isolate characterization using commonly available molecular diagnostic methods

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Edward P. C. Ager ◽  
Eric D. Steele ◽  
Lindsey E. Nielsen ◽  
Matthew A. Nestander ◽  
Katrin Mende ◽  
...  
Keyword(s):  
Breast Milk ◽  
Premature Infants ◽  
Streptococcus Agalactiae ◽  
Early Onset ◽  
Limit Of Detection ◽  
Late Onset ◽  
Perinatal Transmission ◽  
Diagnostic Methods ◽  
Molecular Methods ◽  
Molecular Diagnostic

Abstract Background Group B Streptococcus (GBS) infections caused by Streptococcus agalactiae is a leading cause of meningitis and sepsis in neonates, with early-onset GBS symptoms emerging during the first week of life and late-onset occurring thereafter. Perinatal transmission of GBS to the neonate through the birth canal is the main factor associated with early-onset neonate infections, while less is understood about the source of late-onset infections. Methods In this report we describe a case of twin ex-premature infants who presented one month after birth with GBS septicemia. The mother had been appropriately screened at gestational age 35–37 weeks and laboratory methods failed to detect GBS colonization by culture or clinical molecular methods. In attempts to identify and isolate the source of GBS infection, additional surveillance swabs were collected from the mother at the time of neonate admission. Culture and a commercially available, FDA-cleared molecular PCR assay were performed. Results No GBS was detected from swabs collected from the perianal, thigh/groin or axillary areas. However, expressed breast milk and swabs from the breastmilk pump were positive by both methods. Since simultaneous culture and molecular methods which used breastmilk as a source were performed, investigators ascertained the limit of detection for GBS in breastmilk. The limit of detection was determined to be tenfold lower than that of LIM-broth enriched cultures—the FDA-approved source. Subsequent whole genome sequencing (WGS) analysis of isolates recovered from breastmilk and blood cultures from the infants demonstrated all strains were related and characterized as ST-452. Both infants responded very well to treatment and continued to have no related events or concerns at the two-year follow up appointment. Conclusions Strain type 452 (capsular type IV) has recently emerged as a hypervirulent strain and has previously been documented as causing GBS infections in elderly populations. Antibiotic therapy resolved both mother and infant infections. Subsequent testing for the presence of GBS in breastmilk samples also showed an absence of bacteria. This is the first report of infant twins late-onset GBS infections caused by the hypervirulent S. agalactiae ST-452 with breastmilk as the source.

scholarly journals Acute visceral leishmaniasis in a domestic cat (Felis silvestris catus) from the state of Tocantins, Brazil

2019 ◽  
Vol 40 (4) ◽  
pp. 1723
Author(s):  
Sebastiana Adriana Pereira Sousa ◽  
Helcileia Dias Santos ◽  
Cristiane América de Carvalho ◽  
Aline Marinho Machado ◽  
Letícia Espindola de Oliveira ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Leukemia Virus ◽  
Antibody Test ◽  
The State ◽  
Diagnostic Methods ◽  
Domestic Cat ◽  
Feline Leukemia Virus ◽  
Mesenteric Lymph Nodes ◽  
First Case ◽  
Immunodeficiency Virus

Visceral leishmaniasis (VL) is expanding in the Brazilian territory. Dogs are considered an important urban reservoir; however, studies have demonstrated the presence of infected cats in some Brazilian states. This report aimed to describe a case of Leishmania (Leishmania) infantum infection in a two-month-old domestic feline from a Brazilian region with a high incidence of human visceral leishmaniasis. The analyzed samples were the cat’s blood, conjunctiva, spleen, liver, popliteal, submandibular and mesenteric lymph nodes, skin, lung and kidney. The diagnostic methods were: parasitological examination, polymerase chain reaction (PCR) and an immunoflurescence antibody test (IFAT). All tissues were positive. The title obtained using the IFAT was 1:160. The animal was negative for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). This work addresses the first case of feline leishmaniasis in the state of Tocantins, and reveals data that may contribute to the knowledge of the disease, since it has been shown to be able to develop rapidly and fatally in kittens, with the ability to infect several tissues.

Sign in / Sign up

Export Citation Format

Share Document