scholarly journals Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nicolás Rivera-Valdivia ◽  
Karla Arteaga-Rivera ◽  
Juliana Reyes-Guanes ◽  
Natalia Neira-Segura ◽  
Alejandra de-la-Torre
Keyword(s):  
Bacterial Infections ◽  
Case Reports ◽  
Fourth Generation ◽  
Pigment Dispersion ◽  
Ocular Pain ◽  
Conjunctival Hyperemia ◽  
Blurred Vision ◽  
Case Presentation ◽  
Ahmed Valve ◽  
Valve Implantation

Abstract Background Moxifloxacin is a fourth-generation fluoroquinolone used as a second-line treatment for multiple bacterial infections. Uveitis has been described as an adverse effect related to this medication. Although several case reports have been published describing uveitis and bilateral acute iris transillumination syndrome related to moxifloxacin, we present a unique case of a patient with severe sequelae associated with bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin. Case presentation A 45-year-old Colombian hispanic female presented bilateral conjunctival hyperemia, decreased visual acuity, blurred vision, photophobia, and ocular pain after 15 days of treatment with systemic moxifloxacin for an upper tract respiratory infection. The patient presented unilateral anterior chamber pigment dispersion, mydriatic and nonreactive pupils, extensive iris transillumination defects, and secondary glaucoma. Blood and aqueous humor tests were negative for infectious and autoimmune diseases. Moxifloxacin-induced bilateral acute iris transillumination syndrome was diagnosed. Permanent sequelae such as ocular pain, photophobia, and focus difficulty secondary to severe bilateral iridian atrophy and inability of synkinetic reflex were left. Additionally, glaucoma was diagnosed, and Ahmed valve implantation was required. Conclusions We should be aware of the possible association between moxifloxacin and bilateral acute iris transillumination syndrome. A detailed anamnesis, adequate examination, and laboratory tests are necessary to reach an early diagnosis and treatment to avoid unnecessary therapies. Larger studies should be carried out to understand the pathophysiology, diagnosis, management, and sequelae of the disease.

scholarly journals Euphorbia grandicornis Sap Keratouveitis: A Case Report

2016 ◽  
Vol 7 (1) ◽  
pp. 125-129
Author(s):  
María Gómez-Valcárcel ◽  
Graciana Fuentes-Páez
Keyword(s):  
Complete Resolution ◽  
Sesquiterpene Lactones ◽  
Sodium Hyaluronate ◽  
Conjunctival Hyperemia ◽  
Blurred Vision ◽  
Case Presentation ◽  
Corrected Visual Acuity ◽  
Dexamethasone Phosphate ◽  
Best Corrected Visual Acuity ◽  
Extraction Spectrophotometry

Purpose: To describe a case of keratouveitis caused by Euphorbia grandicornis sap, that resolved with topic steroids. Methods: We report a case presentation of a patient with keratouveitis. Results: A 70-year-old woman suffered from accidental ocular contact with E. grandicornis sap in her left eye. Two hours after the contact, she attended the clinic due to conjunctival hyperemia and pain. Best-corrected visual acuity (BCVA) was 20/25. The toxic conjunctivitis was treated with topical lubricant and steroid. After 24 h, she presented blurred vision. BCVA was 20/80. Toxic keratouveitis was diagnosed. Topical treatment with 1% cyclopentolate t.i.d., 5% sodium chloride, 1.14% dexamethasone phosphate each hour, and 4% sodium hyaluronate each hour was continued. Complete resolution was obtained 1 week later. Euphorbia sap content analysis was performed using dissolvent extraction spectrophotometry. Its contents included flavonoids, alkaloids, phenols and sesquiterpene lactones. Conclusion: Corneal exposure to E. grandicornis sap is a cause of nonvisually threatening keratouveitis when adequately treated with corticosteroids.

Ahmed valve implantation efficiency in children with refractory uveitic glaucoma

2020 ◽  
pp. 144-145
Author(s):  
M.A. Khrabrova ◽  
◽  
L.A. Katargina ◽  
E.V. Denisova ◽  
N.A. Ibaidbahaaeddin ◽  
...  
Keyword(s):  
Uveitic Glaucoma ◽  
Ahmed Valve ◽  
Valve Implantation

Актуальность. Постувеальная глаукома (ПУГ) представляет собой одну из самых тяжелых глауком детского возраста. Имплантации дренажей при ПУГ у детей посвящены лишь единичные работы, а полученные результаты неоднозначны, что требует дальнейшего изучения данного вопроса. Цель. Оценить эффективность имплантации клапана Ахмеда у детей с рефрактерной постувеальной глаукомой (ПУГ). Материал и методы. Имплантация клапана Ахмеда была проведена 10 детям в возрасте от 7 до 17 лет (10 глаз) с некомпенсированной на максимальном гипотензивном режиме открытоугольной или смешанной формой ПУГ. Ранее всем пациентам было выполнено в среднем 2,1±0,9 операций, направленных на нормализацию внутриглазного давления (ВГД). 6 глаз были артифакичными, 2 факичными, 2 афакичными. Имплантация клапана Ахмеда проводилась по общепринятой методике. ВГД на момент операции было в среднем 30,50±4,35 мм рт.ст. Компенсацией глаукомы считали ВГД≤24 мм рт.ст. и отсутствие симптомов прогрессирования глаукомного процесса. Срок наблюдения после операции составил от 3,9 до 23,6 месяцев (в среднем – 14,1±6,5). Результаты. Стойкий гипотензивный эффект вмешательства достигнут в 90% случаев, из них у 3 пациентов без гипотензивного режима, у 6 – на фоне препаратов. Среднее количество гипотензивных препаратов после операции составило 1,7±1,49 (значительно меньше по сравнению с периодом до операции, р=0,028). В конце периода наблюдения среднее значение ВГД составило 18,1±5,34 мм рт.ст. (р=0,008). Во время операции у 1 пациента после парацентеза отмечалось кровотечение из сосудов угла передней камеры, остановленное тампонадой стерильным воздухом. В остальных случаях вмешательство, ближайший и отдаленный послеоперационный период протекали без осложнений. Выводы. Имплантация клапана Ахмеда является эффективным и безопасным способом хирургического лечения рефрактерной ПУГ у детей и может быть рекомендована при неэффективности предшествующих антиглаукоматозных операций, в том числе пациентам с артифакией и афакией.

Postoperative complications after Ahmed valve implantation

2016 ◽  
Vol 12 (2) ◽  
pp. 103-107
Author(s):  
M.M. Bikbov ◽  
◽  
I.I. Husnitdinov ◽  
Keyword(s):  
Postoperative Complications ◽  
Ahmed Valve ◽  
Valve Implantation

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals Recurrent keratoconjunctivitis as the sole manifestation of COVID-19 infection: A case report

2021 ◽  
pp. 112067212110065
Author(s):  
Satria Audi Hutama ◽  
Firas Farisi Alkaff ◽  
Ryan Enast Intan ◽  
Citra Dewi Maharani ◽  
Luki Indriaswati ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Foreign Body Sensation ◽  
Polymerase Chain Reaction Test ◽  
Nasopharyngeal Swab ◽  
Conjunctival Hyperemia ◽  
Blurred Vision ◽  
Ocular Symptoms ◽  
Body Sensation ◽  
Fluorescence Test

Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019 (COVID-19) infection. Earlier study reported that dry eye, blurred vision, foreign body sensation, tearing, itching, conjunctival secretion, conjunctival congestion, ocular pain, and photophobia are among the ocular symptoms that could be found in COVID-19 patients. However, there are only a few reports available regarding corneal involvement in this disease. Here we report a case of keratoconjunctivitis as the only symptom of COVID-19 infection. Case description: A 27-year-old man who worked as an obstetrics and gynecology resident came to the outpatient clinic with the chief complaints of eye discomfort, foreign body sensation, conjunctival hyperemia, lacrimation, and photophobia in his right eye for the past 3 weeks. Fluorescence test showed a small corneal lesion. The patient was then diagnosed with keratoconjunctivitis. A week after the treatment, all symptoms were resolved. A month later, the patient came to the emergency room with the same eye complaints but with a more severe pain. The fluorescence test showed wider corneal lesion compared to last month. The result from the corneal swab is negative for bacterial or fungal infection, indicating a viral infection. Afterwards, reverse transcriptase polymerase chain reaction test from nasopharyngeal swab was performed and revealed that the patient was positive for COVID-19. Conclusions: This case report showed that keratoconjunctivitis may occur as the only manifestation of COVID-19 infection. Thus, patient presented with unexplainable eye symptoms should be evaluated for COVID-19 infection.

scholarly journals Clozapine-induced stuttering in the absence of known risk factors: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Side Effect ◽  
Case Reports ◽  
Extrapyramidal Symptoms ◽  
Prior History ◽  
Case Presentation ◽  
Rare Side Effect ◽  
History Of ◽  
Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

scholarly journals Fibromuscular dysplasia with recurrence after “long-term” following percutaneous transcatheter renal angioplasty: two case reports with a review of 26 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuntaro Oribe ◽  
Takafumi Toyohara ◽  
Eikan Mishima ◽  
Takehiro Suzuki ◽  
Koichi Kikuchi ◽  
...  
Keyword(s):  
Fibromuscular Dysplasia ◽  
Age Of Onset ◽  
Case Reports ◽  
Case Presentation ◽  
Renal Angioplasty ◽  
Long Term Follow Up ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
The Difference

Abstract Background Fibromuscular dysplasia (FMD) often causes renal artery stenosis with renovascular hypertension. Recent clinical outcomes encourage percutaneous transluminal renal angioplasty (PTRA) to treat FMD; however, the necessary follow-up period remains unclear. Moreover, previous studies have not revealed the difference in the period until recurrence between two major types of FMD—multifocal and focal. Case presentation We describe two patients with multifocal FMD who developed hypertension during their teenage years and had recurrence of FMD > 10 years after PTRA. We further examined the types of FMD and age of onset in 26 patients who underwent PTRA. The period until recurrence of multifocal FMD was longer than that of focal FMD. Moreover, patients with early-onset multifocal FMD are likely to have a delayed recurrence after PTRA compared to other types. Conclusions Our report suggests that patients with multifocal FMD, especially those with onset at an early age, may need long-term follow-up for at least ≥ 10 years.

scholarly journals Familial hemiplegic migraine type 2 due to a novel missense mutation in ATP1A2

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fabio Antonaci ◽  
Sabrina Ravaglia ◽  
Gaetano S. Grieco ◽  
Stella Gagliardi ◽  
Cristina Cereda ◽  
...  
Keyword(s):  
Case Reports ◽  
3D Structure ◽  
Familial Hemiplegic Migraine ◽  
Transmembrane Helices ◽  
Hemiplegic Migraine ◽  
Case Presentation ◽  
Italian Family ◽  
Protein Prediction ◽  
Functional Consequences

Abstract Background The mechanisms of genotype-phenotype interaction in Familiar Hemiplegic migraine type 2 (FHM2) are still far from clear. Different ATP1A2 mutations have been described, with a spectrum of phenotypes ranging from mild to severe. No genotype-phenotype correlations have been attempted. Case presentation We describe an Italian family with FHM and a missense ATP1A2 variant (L425H) not previously described. The clinical picture was mild in all the affected members. Conclusions Co-segregation of the variant with the aura phenotype was complete in this family, suggesting a 100% penetrance. In silico protein prediction softwares indicate that this variant may change the 3D structure of ATPA1A2 at the cytoplasmic loop between the two central transmembrane helices. Milder FHM phenotypes are rarely reported in literature, likely because case reports are biased towards the most severe phenotypes, with milder forms possibly misdiagnosed as sporadic migraine with aura forms (MAs), even with complex auras. Further studies taking into account intra-familiar variability and functional consequences on the channel protein may help clarify genotype-phenotype correlations.

scholarly journals Severe pneumonia caused by Parvimonas micra: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yu ◽  
Lingling Sun ◽  
Zuqing Xu ◽  
Lumei Fan ◽  
Yunbo Du
Keyword(s):  
Bronchoalveolar Lavage Fluid ◽  
Case Reports ◽  
Severe Pneumonia ◽  
Lavage Fluid ◽  
Due Date ◽  
Case Presentation ◽  
Abdominal Abscesses ◽  
Parvimonas Micra ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Abstract Background Parvimonas micra (P. micra) is a gram-positive anaerobic coccus that is detected widely on the skin, in the oral mucosa and in the gastrointestinal tract. In certain circumstances, P. micra can cause abdominal abscesses, bacteraemia and other infections. To the best of our knowledge, there have been no case reports describing the biological characteristics of P. micra-related pneumonia. These bacteria do not always multiply in an aerobic organ, such as the lung, and they could be easily overlooked because of the clinical mindset. Case presentation A 35-year-old pregnant woman was admitted to the emergency department 4 weeks prior to her due date who was exhibiting 5 points on the Glasgow coma scale. A computed tomography (CT) scan showed a massive haemorrhage in her left basal ganglia. She underwent a caesarean section and brain surgery before being admitted to the ICU. She soon developed severe pneumonia and hypoxemia. Given that multiple sputum cultures were negative, the patient’s bronchoalveolar lavage fluid was submitted for next-generation sequencing (NGS) to determine the pathogen responsible for the pneumonia; as a result, P. micra was determined to be the causative pathogen. Accordingly the antibiotic therapy was altered and the pneumonia improved. Conclusion In this case, we demonstrated severe pneumonia caused by the anaerobic organism P. micra, and the patient benefited from receiving the correct antibiotic. NGS was used as a method of quick diagnosis when sputum culture failed to distinguish the pathogen.

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