scholarly journals COVID-19 ocular findings in paediatric population

Author(s):  
Celia Fernandez Alcalde ◽  
Maria Granados Fernandez ◽  
María Nieves Moreno ◽  
Susana Noval Martin

Abstract Purpose To investigate and describe ocular findings in COVID-19 paediatric patients. Methods A total of 17 COVID-19 patients aged between 0 and 17 years old were recruited at the Paediatric Hospital of La Paz University Hospital (Madrid, Spain). A complete ophthalmological examination was performed in all patients. Results Of 17 patients, 50% had a known COVID-19 previous exposure. PCR from nasopharyngeal swabs was positive in 35.29%, whereas IgM and/or IgG serology tests were positive in 81%. Clinical manifestations were: 6 COVID-19associated Paediatric Inflammatory Multisystem Syndrome (PIMS), 7 pneumonias and 2 cutaneous purpura and/or chilblains. Ocular findings were ocular hyperaemia (5 patients), as bilateral acute conjunctivitis (3 patients) or unilateral episcleritis (2 patients). Mean best corrected visual acuity was 1/1 in all tested cases. Only one patient, presenting unilateral optic neuritis, had visual symptoms as unilateral inferior temporal quadrantanopsy. Retinal involvement was found in one patient, where ocular fundus exam showed unilateral retinal vasculitis. Conclusion SARS-CoV-2 infection could produce ocular pathology in children, frequently presented weeks after the acute phase of the disease. We should take into account COVID-19 when performing differential diagnosis of children presenting with conjunctivitis, episcleritis, retinal vasculitis and/or optic neuritis, meanwhile this world-wide pandemic lasts.

2020 ◽  
Vol 26 (4) ◽  
pp. 116-121
Author(s):  
T.I. Nehrych ◽  
◽  
M.B. Kopchak ◽  
S.Ya. Kyryliuk ◽  
◽  
...  

Aim. To study the features of the clinical course, diagnosis and treatment of chronic relapsing inflammatory optic neuropathy based on clinical cases. Materials and Methods. Clinical cases of chronic relapsing inflammatory optic neuropathy in two men are presented. The patients underwent neurological and ophthalmological examination, laboratory blood tests, testing of cerebrospinal fluid, magnetic resonance imaging of the brain and spinal cord, perimetry, ophtalmoscopy, optical coherence tomography, ultrasound examination of internal organs and of the branches of the aortic arch, and chest radiography. Results and Discussion. Two cases of chronic relapsing inflammatory optic neuropathy were described in two men aged 44 and 22 years. Episodes of recurrent optic neuritis, both unilateral and bilateral, were observed in patients; their vision improved after corticosteroid therapy. No etiological factors or comorbidities capable of causing the condition were identified. The older patient had 8 attacks of recurrent optic neuritis, with complete recovery of vision after therapy in seven cases, and partial recovery after the last relapse . The 22-year-old patient endured 5 episodes without complete recovery of vision after treatment. Based on the diagnostic criteria of chronic recurrent inflammatory optic neuropathy, this diagnosis was suspected in the patients. Conclusions. Chronic relapsing inflammatory optic neuropathy is a rare pathology whose clinical manifestations must meet diagnostic criteria. Patients with recurrent optic neuritis are to be well examined, in order to make a correct diagnosis and prescribe adequate therapy. Clinical manifestations of chronic relapsing inflammatory optic neuropathy tend to regress and stabilize against a background of immunosuppressive therapy. Keywords: chronic relapsing inflammatory optic neuropathy, clinical cases


2012 ◽  
pp. 74-84
Author(s):  
Thi Kieu Nhi Nguyen

Objectives: 1. Estimating the ratios of clinical and paraclinical signs of post-term newborns hospitalized at Pediatric Department of Hue University Hospital. 2. Identifying the relation between clinical signs and paraclinical signs. Materials and Method: 72 post- term babies < 7 days of life hospitalized at NICU from 2010/5 to 2011/4. Classification of post - term newborn was based on WHO 2003: gestational age ≥ 42 weeks with clinical manifestations: desquamation on press with fingers or natural desquamation, withered or meconial umbilicus, meconial long finger nails (*) or geatational age still < 42 weeks with theses clinical manifestations (*). Data were recorded on a clinical record form. Per-protocol analysis of clinical outcomes was performed by using Medcalc 11.5 and Excell 2007. Analyses used the χ2 test or Fisher's exact test for categorical data; Student's t test was used for continuous data and the Mann-Whitney U test for nonparametric data. Data were presented as means or proportions with 95% CIs. Results: Clinical characteristics: Tachypnea and grasp were main reasons of hospitalisation (48.61%). Poor feeding, vomitting (16.67%). Asphyxia (8.34%). Jawndice (6.94%). Hypothermia < 36.50C (13.89%), fever (13.89%). Tachypnea (59.72%). Bradycardia (1.39%). Poor feeding (11.11%). Hypertonia (9.72%). Paraclinical characteristics: Erythrocytes < 4.5.1012/l (51.39%), Leucocytes 5 – 25.103/mm3 (81.94%), Thrombocytes 100- 400.103/mm3 (94.44%). Hemoglobinemia < 10mg/l (67.61%). Maternal characteristics: Menstrual cycles regular (75%). Primiparity (75%). Amniotic volume average (70.42%), little (29.58%). Aminiotic liquid clair (62.5%), aminiotic liquid yellow (4.17%), aminiotic meconial liquid (33.33%). Maternal manifestation of one of many risk factors consist of genital infection; urinary infection; fever before, during, after 3 days of birth; prolonged delivery; medical diseases influence the foetus (75%). The relation between clinical signs and paraclinical signs: There was significantly statistical difference: between gestationnal age based on obstetrical criteria and amniotic volume on ultrasound (p < 0.05); between birth weight and glucosemia p < 0.02). There was conversional correlation of average level between erythroctes number and respiratory rate (r = - 0.5158; p < 0,0001), concordance correlation of weak level betwwen leucocytes number and respiratory rate r = 0.3045; p = 0.0093). Conclusion: It should made diagnosis of postterm baby based on degree of desquamation. The mother who has menstrual cycles regular is still delivered of a postterm baby. A postterm baby has the individual clinical and paraclinical signs.


2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1108.1-1108
Author(s):  
D. Monova ◽  
S. Monov ◽  
R. Shumnalieva ◽  
D. Dimova ◽  
M. Sotirova

Background:Rheumatoid arthritis (RA) is the most common systemic autoimmune disease and is associated with a number of extra-articular organ manifestations, including ocular complications.Objectives:The aim of this study is to evaluate the frequency and characteristics of ocular manifestation in patients with rheumatoid arthritis (RA).Methods:The study involved 87 patients with RA. All the study subjects underwent complete ophthalmological examination involving visual acuity assessment, examination of anterior and posterior eye segments, Schirmer’s test, diameter and mobility of pupils, as well as eyeball mobility assessment of intraocular pressure. Data regarding age, gender, disease duration, age at diagnosis, systemic corticosteroid use, blood pressure, ocular symptoms and detailed ophthalmic history were recorded. The presence of rheumatoid factor in serum was evaluated by standard test methods based on principle of agglutination. All patients were seropositive.Results:87 patients (26 male, 59 female, mean age 45,6 ± 13,1 years; mean disease duration 7,4 ± 6,2 years) with RA were enrolled in this study. 31 (35,63 %) of them had no ocular symptoms. Among the patients with ocular symptoms, 39 (69,64 %) complained of decreased vision, 33 (58,93 %) - of dry eye, 32 (57,14 %) - of burning, 29 (51,78 %) -photophobia, 28 (50 %) - of gritty sensation, 27 (48,21 %) - of itching, 18 (32,14 %) - of redness, 13 (23,21 %) - of ocular pain, 3 (5,36 %) - of floaters. Ophthalmological examination revealed higher incidence of the following abnormalities in the study group: myopic astigmatism - in 10 (5,74 %) eyes, vascular abnormalities within fundus - in 22 (12,64 %) eyes, increased intraocular pressure (> 21 mm Hg) - in 11 (6,32 %) eyes. Mean IOP values were 17,34 ± 5,12 mm Hg. In 48 eyes Schirmer’s test results were below 10 mm, and in 18 eyes - below 5 mm. Keratoconjunctivitis sicca was present in 31 (35,63 %) of all patients. Episcleritis was diagnosed in 4 patients (4,6 %), scleritis – in 3 (3,45 %). Retinal vasculitis was present in 2 (2,3 %) patients and involves veins and arteries peripheral branches. Lens opacity was found in 13 (14,94 %) patients (21 eyes), mostly in the form of posterior subcapsular cataract (in 16 eyes) and nuclear cataract (in 5 eyes). The mean age of patients with cataracts was 52,3 ± 14,2 years. 13 of the patients with cataracts were either currently taking or had previously taken systemic corticosteroids.Conclusion:In patients with RA numerous abnormalities within the vision of organ may be found. Ocular symptoms are relatively common complications of RA, and may result in irreversible changes in the organ of vision. Regular ophthalmological examinations are essential among the patients with RA.Disclosure of Interests:None declared


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1284.1-1285
Author(s):  
A. S. Lundberg ◽  
B. A. Esbensen ◽  
E. M. Hauge ◽  
A. De Thurah

Background:Early treatment, before three months from symptom onset of rheumatoid arthritis (RA), is essential to increase the likelihood of remission and to prevent permanent joint damage (1). However, it has been shown that only 20% of the patients are seen within the first three months, and the median delay in general practice has been estimated to 4 months (range 2–9) (2).Objectives:To explore the barriers in diagnosing RA from the general practitioners’ (GPs) perspective.Methods:We conducted a qualitative study based on focus group interviews. We recorded the interviews digitally and transcribed verbatim. The transcribed interviews were analyzed based on content analysis (3), by using Nivo 12. Sample size was determined by thematic saturation.Results:In total ten GPs participated in three different focus groups. 40 % were female, mean age was 53 years (range 37-64), and mean year since specialist authorization as GP was 16 years (range 5-23). 60 % of the GPs worked in a practice located within the referral area of a university hospital; the remaining within the referral area of a regional hospital.Four themes emerged in the analysis: 1) When the patient is not a text book example, referring to the difficulty of identifying relevant symptoms among all clinical manifestations from the joints as described by the patients, 2)The importance of maintaining the gatekeeper function, referring to the societal perspective, and the GPs responsibility to refer the right patients to secondary care, 3)Difficulties in referral of patients to the rheumatologist,referring to perceived differences in the collaboration with rheumatologists. The GPs experienced that it was sometimes difficult to be assisted by rheumatologists, especially when the clinical picture was not ‘clear cut’. Finally, (4)Para-clinical testing, can it be trusted?referring to challenges on the evaluation of especially biomarkers.The overarching theme was:Like finding a needle in a haystack, covering the GPs difficulties in detecting RA among the many patients in general practice who appear to be well and at the same time have symptoms very similar to RA.Conclusion:The GPs experienced that RA was a difficult diagnosis to make. The immediate challenge was that RA patient’s initial symptoms often resembled those of more common and less serious conditions, and that investigative findings such as biomarkers can be negative at the early state of the disease. At the same time, the collaboration with rheumatologists was sometimes seen as a hurdle, when the clinical picture was not ‘clear cut’.In order to facilitate earlier diagnosis of RA in general practice, the GPs and rheumatologists need to focus on these barriers by strengthening mutual information and collaboration.Physicians should remain vigilant to patients who have conditions that do not resolve as expected with treatment, who have symptoms that persist, or who do not look well despite negative investigative findings.References:[1]Aletaha D, et al. JAMA, Oct 2018.[2]Kiely P, et al. Rheumatology, Jan 2009.[3]Braun V. Qualitative research in psychology. 2006, 3(2), 77-101Disclosure of Interests:Anne Sofie Lundberg: None declared, Bente Appel Esbensen: None declared, Ellen-Margrethe Hauge Speakers bureau: Fees for speaking/consulting: MSD, AbbVie, UCB and Sobi; research funding to Aarhus University Hospital: Roche and Novartis (not related to the submitted work)., Annette de Thurah Grant/research support from: Novartis (not relevant for the present study)., Speakers bureau: Lily (not relevant for the present study).


2018 ◽  
Vol 49 (1) ◽  
pp. 59-61 ◽  
Author(s):  
Manijeh Nourian ◽  
Aliehsan Heidari ◽  
Saleheh Tajali ◽  
Erfan Ghasemi ◽  
Mehdi Mohebali ◽  
...  

Visceral leishmaniasis (VL) is a neglected disease. Our retrospective study describes 38 clinical and epidemiological characteristics of VL in patients admitted to a paediatric hospital in Tehran, Iran, who came from different geographical regions, indicating that the disease has spread to most parts of the country. Some 76.3% of the children documented suffered with symptoms of the disease for two months before admission.


2021 ◽  
Vol 14 (4) ◽  
pp. 52-59
Author(s):  
L. A. Katargina ◽  
V. V. Kadyshev ◽  
E. V. Denisova ◽  
E. A. Geraskina ◽  
A. V. Marakhonov ◽  
...  

Familial exudative vitreoretinopathy (FEVR)is a rare genetically heterogeneous disease with multiple types of inheritance (autosomal dominant, autosomal recessive, X-linked) and widely varying clinical features. Up to 40 % of cases of FEVR are associated with mutations of the FZD4 gene.Purpose: to investigate the clinical manifestations of FEVR in children with nucleotide sequence alterations in the FZD4 gene. Material and methods. The Helmholtz National Medical ResearchCenter of Eye Diseases and the ResearchCentre for MedicalGenetics conducted a joint in-depth ophthalmological examination of 18 patients aged from 3 weeks to 17 years with a diagnosis of FEVR, which included a detailed ophthalmoscopy under drug mydriasis, ultrasound and electrophysiological examination, photographic recording of fundus changes using RetCam and Fundus Foto. Molecular genetic examination was carried out by direct sequencing according to Sanger. Results. Nucleotide sequence alterations in the FZD4 gene were detected in 3 patients(16.7 %)from two unrelated families. In one family, a 12-year-old girl wasfound to display the firstsymptoms of ophthalmic pathology (reduced vision, strabismus) at the age of 3.5 years. In another family, the clinical manifestations of FZD4 gene mutations were observed in two children during the first year of life (at the age of 5 and 11 months).Conclusions. The clinical picture of 3 patients with detected changes in the nucleotide sequence of the FZD4 gene is characterized by early manifestation and bilateral asymmetric ophthalmoscopic damage. The results of the study indicate the need for a timely diagnosis of FEVR in young children, recommend an interdisciplinary approach to the study of the disease, which should contribute to a better understanding of pathogenesis, and the development of an effective diagnostic, treatment and rehabilitation algorithm.


2005 ◽  
Vol 10 (5) ◽  
pp. 7-8 ◽  
Author(s):  
S Vourli ◽  
D Perimeni ◽  
A Makri ◽  
M Polemis ◽  
A Voyiatzi ◽  
...  

We investigated the characteristics of 20 community acquired methicillin resistant Staphylococcus aureus (MRSA) strains isolated in a paediatric hospital in Athens. Eighteen of these, all isolated from skin and soft tissue infections, carried the Panton-Valentine leukocidin (PVL) determinants. They all were found resistant to fusidic acid, tetracycline and kanamycin, and displayed a PFGE pattern identical to that of the well-described ST80 CA-MRSA clone circulating in various European countries.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Zeineb Zian ◽  
Mouna Maamar ◽  
Mohamed El Aouni ◽  
Amina Barakat ◽  
Naima Ghailani Nourouti ◽  
...  

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease with a high female predominance. To date, studies about SLE in Morocco are few. This retrospective study describes the clinical and immunological features in a series of 50 SLE Moroccan patients in University Hospital Center of Rabat, Morocco, between December 2011 and December 2013. All patients were screened for antinuclear antibodies (ANA) and anti-DNA antibodies by indirect immunofluorescence, followed by identification of anti-extractable nuclear antigen antibodies by ELISA. The female to male ratio was 6.1:1. Mean age was 31.72 years. The main clinical manifestations were arthritis (82%), mucocutaneous manifestations (80%), renal manifestations (50%), and hematological features (46%). Of the mucocutaneous features, the highest frequencies were observed in the malar rash (68%) and photosensitivity (60%). Of the hematological features, lymphopenia was most frequently observed in 30% of patients, followed by hemolytic anemia in 16% and leucopenia and thrombocytopenia in 8%. Central nervous system was involved in 10%. ANA were found in 88%, anti-DNA antibodies in 56%, and anti-Sm antibodies in 50%. Anti-SSA, anti-SSB, anti-Sm/RNP, and anti-Scl70 antibodies were detected in 38%, 10%, 48%, and 8%, respectively. Our data show that, in our patients, the main clinical and immunological features of SLE remain comparable to patients from other Arab countries.


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