scholarly journals Clinico-microbiological profile of Burkholderia cepacia keratitis: a case series

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ming-Chih Ho ◽  
Eugene Yu-Chuan Kang ◽  
Lung-Kun Yeh ◽  
David H. K. Ma ◽  
Hsin-Chiung Lin ◽  
...  
Keyword(s):  
Burkholderia Cepacia ◽  
Case Series ◽  
Opportunistic Pathogen ◽  
Drug Susceptibility ◽  
Ocular Disease ◽  
Herpetic Keratitis ◽  
Chang Gung Memorial Hospital ◽  
Predisposing Factor ◽  
Medical Treatments ◽  
Visual Outcomes

Abstract Background Burkholderia cepacia, an opportunistic pathogen mainly affecting patients with cystic fibrosis or immunocompromised, has rarely been documented as a cause of corneal infection. The clinical and microbiological profiles of B. cepacia keratitis are reported herein. Methods We retrospectively reviewed the medical record of 17 patients with culture-proven B. cepacia keratitis, treated between 2000 and 2019 at Chang Gung Memorial Hospital, Taiwan. Our data included predisposing factors, clinical presentations, treatments, and visual outcomes of B. cepacia keratitis as well as the drug susceptibility of the causative agent. Results The most common predisposing factor for B. cepacia keratitis was preexisting ocular disease (seven, 41.2%), particularly herpetic keratitis (five). Polymicrobial infection was detected in seven (41.2%) eyes. All B. cepacia isolates were susceptible to ceftazidime. Main medical treatments included levofloxacin or ceftazidime. Surgical treatment was required in five (29.4%) patients. Only four (23.5%) patients exhibited final visual acuity better than 20/200. Conclusions B. cepacia keratitis primarily affects patients with preexisting ocular disease, particularly herpetic keratitis, and responds well to ceftazidime or fluoroquinolones. However, the visual outcomes are generally poor.

scholarly journals Clinico-microbiological Profile of Burkholderia cepacia Keratitis: a Case Series

2020 ◽  
Author(s):  
Ming-Chih Ho ◽  
Eugene Yu-Chuan Kang ◽  
Lung-Kun Yeh ◽  
David HK Ma ◽  
Hsin-Chiung Lin ◽  
...  
Keyword(s):  
Burkholderia Cepacia ◽  
Case Series ◽  
Opportunistic Pathogen ◽  
Drug Susceptibility ◽  
Ocular Disease ◽  
Herpetic Keratitis ◽  
Chang Gung Memorial Hospital ◽  
Predisposing Factor ◽  
Medical Treatments ◽  
Visual Outcomes

Abstract Background: Burkholderia cepacia, an opportunistic pathogen mainly affecting patients with cystic fibrosis or immunocompromised, has rarely been documented as a cause of corneal infection. The clinical and microbiological profiles of B. cepacia keratitis are reported herein.Methods: We retrospectively reviewed the medical record of 17 patients with culture-proven B. cepacia keratitis, treated between 2000 and 2019 at Chang Gung Memorial Hospital, Taiwan. Our data included predisposing factors, clinical presentations, treatments, and visual outcomes of B. cepacia keratitis as well as the drug susceptibility of the causative agent.Results: The most common predisposing factor for B. cepacia keratitis was preexisting ocular disease (seven, 41.2 %), particularly herpetic keratitis (5). Polymicrobial infection was detected in seven (41.2 %) eyes. All B. cepacia isolates were susceptible to ceftazidime. Main medical treatments included levofloxacin or ceftazidime. Surgical treatment was required in five (29.4 %) patients. Only four (23.5 %) patients exhibited final visual acuity better than 20/200.Conclusions: B. cepacia keratitis primarily affects patients with preexisting ocular disease, particularly herpetic keratitis, and responds well to ceftazidime or fluoroquinolones. However, the visual outcomes are generally poor.

scholarly journals Clinico-microbiological Profile of Burkholderia cepacia Keratitis: a Case Series

2020 ◽  
Author(s):  
Ming-Chih Ho ◽  
Eugene Yu-Chuan Kang ◽  
Lung-Kun Yeh ◽  
David HK Ma ◽  
Hsin-Chiung Lin ◽  
...  
Keyword(s):  
Burkholderia Cepacia ◽  
Case Series ◽  
Drug Susceptibility ◽  
Ocular Disease ◽  
Herpetic Keratitis ◽  
Chang Gung Memorial Hospital ◽  
Predisposing Factor ◽  
Medical Treatments ◽  
Visual Outcomes ◽  
Clinical Presentations

Abstract Background Burkholderia cepacia, a pathogen, has rarely been documented as a cause of corneal infection. The clinical and microbiological profiles of B. cepacia keratitis are reported herein. Methods We retrospectively reviewed the medical record of 17 patients with culture-proven B. cepacia keratitis, treated between 2000 and 2019 at Chang Gung Memorial Hospital, Taiwan. Our data included predisposing factors, clinical presentations, treatments, and visual outcomes of B. cepacia keratitis as well as the drug susceptibility of the causative agent. Results The most common predisposing factor for B. cepacia keratitis was preexisting ocular disease (7, 41.2%), particularly herpetic keratitis (5). Polymicrobial infection was detected in 7 (41.2%) eyes. All B. cepacia isolates were susceptible to ceftazidime. Main medical treatments included levofloxacin or ceftazidime. Surgical treatment was required in 5 (29.4%) patients. Only 4 (23.5%) patients exhibited final visual acuity better than 20/200. Conclusions B. cepacia keratitis primarily affects patients with preexisting ocular disease, particularly herpetic keratitis, and responds well to ceftazidime or fluoroquinolones. However, the visual outcomes are generally poor.

scholarly journals Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK

2021 ◽  
Vol 10 (11) ◽  
pp. 2478
Author(s):  
Majid Moshirfar ◽  
David G. West ◽  
Chase M Miller ◽  
William B. West ◽  
Shannon E. McCabe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
High Myopia ◽  
Case Series ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Incidence Risk ◽  
Mechanical Devices

Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.

scholarly journals The impact of using primaquine without prior G6PD testing: a case series describing the obstacles to the medical management of haemolysis

2019 ◽  
Vol 4 ◽  
pp. 25 ◽  
Author(s):  
Cindy S. Chu ◽  
Germana Bancone ◽  
Nay Lin Soe ◽  
Verena I. Carrara ◽  
Gornpan Gornsawun ◽  
...  
Keyword(s):  
Health Care Providers ◽  
G6pd Deficiency ◽  
Case Series ◽  
Radical Cure ◽  
Care Providers ◽  
Medical Treatments ◽  
Normal Individuals ◽  
High Index Of Suspicion ◽  
Glucose 6 Phosphate Dehydrogenase ◽  
The Impact

Radical cure of Plasmodium vivax malaria in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals employs weekly primaquine dosing. This is the only recommended regimen for this patient sub-group. If national malaria programs mandate daily primaquine dosing (the recommended regimen for G6PD normal individuals), then G6PD testing before prescription is necessary to avoid iatrogenic haemolysis in G6PD deficient individuals. In this case series, two P. vivax infected patients with unknown G6PD status from two different countries were prescribed primaquine as per national malaria program guidelines. During treatment both patients presented to the clinic with symptoms of anaemia after taking primaquine incorrectly. The clinical management of the iatrogenic severe haemolysis that occurred in these patients demonstrates the various adverse effects primaquine can cause, that other common medical treatments also have haemolytic potential, and how the diagnosis of G6PD deficiency can be elusive during acute haemolysis. Health care providers should provide careful instructions about primaquine dosing, be watchful for haemolysis, and have a high index of suspicion for G6PD deficiency in the presence of haemolysis if the G6PD status is previously unknown.

Burkholderia cepacia. [Descriptions of Fungi and Bacteria].

1994 ◽  
Author(s):  
G. S. Saddler
Keyword(s):  
Cystic Fibrosis ◽  
Lycopersicon Esculentum ◽  
Geographical Distribution ◽  
Allium Cepa ◽  
Leaf Spot ◽  
Burkholderia Cepacia ◽  
Allium Sativum ◽  
Opportunistic Pathogen ◽  
Agaricus Bitorquis ◽  
Cultivated Mushroom

Abstract A description is provided for Burkholderia cepacia. Information is included on the disease caused by the organism, its transmission, geographical distribution, and hosts. HOSTS: Common host is Allium cepa, but can also cause disease in Allium sativum. Also identified as causing disease in Lycopersicon esculentum (63, 3168), a cavity disease of a cultivated mushroom (Agaricus bitorquis) (72, 5605) and a leaf spot on the a number of orchids including Cymbidium spp., Dendrobium sp. and Paphiopedilum spp. (66, 4326). The bacterium can also be found in soil, in clinical material, in disinfectant solutions and as an opportunistic pathogen of man and animals. It is gaining in significance as a major pathogen for sufferers of cystic fibrosis (Isles et al., 1984; McKevitt & Woods, 1984; Thomassen et al., 1985). DISEASE: Onion slippery skin; this is a rot of bulb scales, usually occurring at or near maturity, sometimes in storage. The bacterium does not appear to be strongly invasive, attacking plants that are damaged or weakened. Bacteria are thought to gain entry through the neck or leaf blades as the foliage falls over and the epidermis breaks, at maturity (64, 5550). GEOGRAPHICAL DISTRIBUTION: Worldwide. TRANSMISSION: Appears to be a soilborne wound pathogen.

scholarly journals Comparison of visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses

2020 ◽  
Vol 40 (10) ◽  
pp. 2553-2562
Author(s):  
Wojciech Lubiński ◽  
Karolina Podborączyńska-Jodko ◽  
Marta Kirkiewicz ◽  
Maciej Mularczyk ◽  
Michał Post
Keyword(s):  
Case Series ◽  
Cataract Extraction ◽  
Intraocular Lenses ◽  
Group Differences ◽  
Difficult Situation ◽  
Iol Implantation ◽  
Visual Outcomes ◽  
Defocus Curve ◽  
The Mean ◽  
Prospective Case Series

Abstract Purpose To compare visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses (IOLs). Methods All subjects underwent sequential bilateral cataract extraction with AtLisa tri 839 MP or Symfony IOL implantation. The design is prospective case series. Each group consists of 20 patients (40 eyes). At 1 year postoperatively, the following parameters were analysed: binocular uncorrected visual acuity (log MAR): for distance (UDVA) at 4 m, for intermediate distances (UIVA) at 60, 70, 80 cm and for near (UNVA) at 40 cm, defocus curve, mesopic and photopic contrast sensitivities (CSs), spectacle independence, visual function test questionnaire modified VFQ-25), photopic phenomena and postoperative complications. Results In the AtLisa tri 839 MP group, the mean binocular UNVA and UIVA were significantly better than in the Symfony group (UNVA: − 0.01 ± 0.04 vs. 0.21 ± 0.15; p = 0.000; 60 cm UIVA: − 0.01 ± 0.04 vs. 0.09 ± 0.09, p = 0.001; 70 cm UIVA − 0.05 ± 0.06 vs. 0.11 ± 0.08, p = 0.002; 80 cm UIVA − 0.01 ± 0.06 vs. 0.15 ± 0.08, p = 0.019). There were no significant between-group differences in the mean binocular UDVA and CS, with one exception: the mean binocular distance CS (18 cpd) under mesopic conditions was significantly better in the Symfony group than in the AtLisa tri 839 MP group (1.39 ± 0.22 vs. 1.17 ± 0.27; p = 0.015). The defocus curve analysis revealed significant between-group differences at vergences of 2.0 to − 4.0 D (p < 0.05), except for 2.0, 1.0, 0 and − 1.5. All subjects in AtLisa tri 839 MP group and 18 subjects (90%) in Symfony group were spectacle independent. Patients from both groups highly rated their overall vision quality in the VFQ-25 (1.67 ± 0.47 vs. 1.85 ± 0.5 in the Symfony and AtLisa tri 839 MP group, respectively, p = NS). The scores for daytime driving (1.00 ± 0.00 vs. 1.21 ± 0.36; p = 0.002), night driving (1.57 ± 0.55 vs. 2.13 ± 1.15; p = 0.027) and difficult situation driving (1.14 ± 0.31 vs. 1.53 ± 0.56; p = 0.049) were significantly better in the AtLisa tri 839 MP group than in the Symfony group. The incidence and perception level of halo and glare were significantly reduced (p = 0.00) in the Symfony group as compared to the AtLisa tri 839 MP group. The postoperative course was uneventful in all subjects. Conclusions Visual outcomes achieved with both IOLs are comparable. In both groups, 90% of patients achieved spectacle independence. Whereas the AtLisa tri 839 MP IOL implantation was associated with slightly better intermediate distance VA and significantly better near VA, photic phenomena were less perceived by patients with Symfony IOLs.

scholarly journals Vision improvement in severe acute isolated optic neuritis after plasma exchange treatment in Chinese population: a prospective case series study

2020 ◽  
Vol 13 ◽  
pp. 175628642094797
Author(s):  
Shaoying Tan ◽  
Tsz Kin Ng ◽  
Quangang Xu ◽  
Mo Yang ◽  
Yuan Zhuang ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Plasma Exchange ◽  
Time Window ◽  
Case Series ◽  
Visual Outcome ◽  
Chinese Patients ◽  
High Dose ◽  
Visual Outcomes ◽  
Double Filtration Plasmapheresis ◽  
Case Series Study

Background: Plasma exchange (PE) is often considered as an effective treatment for neuromyelitis optica spectrum disorder (NMOSD) and several inflammatory demyelinating disorders of the central nervous system. This study aimed to evaluate the visual outcomes of Chinese patients with severe acute isolated optic neuritis (ON) who received PE therapy after high-dose intravenous methylprednisolone (IVMP) treatment. Methods: Thirty-seven acute isolated ON patients experiencing their first attack of severe visual impairment without neurological disability were recruited. All subjects received five cycles of double-filtration plasmapheresis. Visual acuity (VA) was documented at onset, 1 day before PE treatment, at each cycle of PE therapy and at the 1-month follow-up visit. Results: This study included 26 female (70.3%) and 11 male (29.7%) subjects, and 18 subjects (48.6%) had bilateral involvement. The time window between onset and PE treatment was 27.3 ± 12.7 days (range: 6–53 days). Mean VA (logMAR) of the studied eyes at onset, 1-day before PE treatment/after IVMP and after the fifth PE treatment were 3.41 ± 1.50, 2.61 ± 1.64 and 1.66 ± 1.52, respectively ( p < 0.001). Nineteen eyes (51.4%) showed no light perception at the onset, and 17 eyes (45.9%) improved to Snellen VA >20/800 after IVMP and PE treatments, among which five eyes (13.5%) recovered to Snellen VA 20/20 ( p < 0.001). Predictors of good visual outcome included body mass index [odds ratio (OR) = 0.734, p = 0.044], serum AQP4 antibody-positive status (OR = 0.004, p = 0.001), bilaterality (OR = 0.042, p = 0.008) and time window from onset to PE therapy per 1 day (OR = 0.79, p = 0.002). Conclusion: This study revealed that PE treatment effectively improves the visual outcomes of patients experiencing their first attack of severe acute isolated ON after high-dose IVMP treatment. Better visual outcomes can be achieved with early PE treatment.

Sign in / Sign up

Export Citation Format

Share Document