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 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 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 Case series on variable presentations of tuberculosis of the breast

2020 ◽  
Vol 13 (12) ◽  
pp. e236019
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Jeyakumar Sundaraj ◽  
Pradeep Joshua Christopher ◽  
Ramyasree Paladugu
Keyword(s):  
Clinical Presentation ◽  
Case Series ◽  
Common Type ◽  
Breast Abscess ◽  
Breast Lump ◽  
Clinical Presentations ◽  
Malignant Lesions

Tuberculosis (TB) of the breast is extremely rare and is often mistaken for benign or malignant lesions of the breast. They are rare even in countries which are endemic for TB, like India. The most common type of clinical presentation is a vague lump in the breast, but there are even other types of presentations which are documented. In olden days, there was a lot of dilemma and challenge in diagnosing TB of the breast, but thanks to improved pathological knowledge and the advent of investigations such as QuantiFERON-TB gold and GeneXpert, TB can be diagnosed early nowadays and treated accordingly. In this study series, we report 10 cases of TB of the breast with variable clinical presentations as fibroadenosis, breast abscess, duct ectasia and breast lump on evaluation, and the challenges encountered in establishing the diagnosis.

scholarly journals Acute abdomen in children due to different presentations of complicated Meckel’s diverticulum: a case series

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Hisham A. Almetaher ◽  
Mohammed Awad Mansour
Keyword(s):  
Congenital Abnormality ◽  
Wedge Resection ◽  
Meckel’S Diverticulum ◽  
Case Series ◽  
Postoperative Outcome ◽  
Meckel's Diverticulum ◽  
Gastrointestinal Disorders ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Small Base

Abstract Background Meckel’s diverticulum (MD) is the commonest congenital abnormality of the gastrointestinal tract that occurs in 2% of general population. It remains asymptomatic, but it may lead to life-threatening complications. These complications may be misdiagnosed with other gastrointestinal disorders like acute appendicitis, making its diagnosis challenging among pediatricians and pediatric surgeons. In this study, we reported five cases with different presentations of complicated MD in children. Results Five patients with different presentations of MD were reported during the period from January 2016 to January 2020. Patients’ demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed. Conclusions The present study highlights different presentations of MD. Surgical interference is the main key of treatment of symptomatic MD either by wedge resection of a small base diverticulum or by resection anastomosis of the small intestine in wide base and inflamed diverticulum.

scholarly journals Sclerosing Mesenteritis: Diverse clinical presentations and dissimilar treatment options. A case series and review of the literature

2011 ◽  
Vol 4 (1) ◽  
pp. 17 ◽  
Author(s):  
Konstantinos Vlachos ◽  
Fotis Archontovasilis ◽  
Evangelos Falidas ◽  
Stavros Mathioulakis ◽  
Stefanos Konstandoudakis ◽  
...  
Keyword(s):  
Treatment Options ◽  
Case Series ◽  
Sclerosing Mesenteritis ◽  
Review Of The Literature ◽  
Clinical Presentations

scholarly journals Germline PRKACA amplification causes variable phenotypes that may depend on the extent of the genomic defect: molecular mechanisms and clinical presentations

2015 ◽  
Vol 172 (6) ◽  
pp. 803-811 ◽  
Author(s):  
Maya B Lodish ◽  
Bo Yuan ◽  
Isaac Levy ◽  
Glenn D Braunstein ◽  
Charalampos Lyssikatos ◽  
...  
Keyword(s):  
Copy Number ◽  
Molecular Mechanisms ◽  
De Novo ◽  
Genetic Defect ◽  
Molecular Cytogenetics ◽  
Case Series ◽  
Sporadic Case ◽  
Genomic Rearrangements ◽  
Clinical Presentations ◽  
Depth Analysis

ObjectiveWe have recently reported five patients with bilateral adrenocortical hyperplasia (BAH) and Cushing's syndrome (CS) caused by constitutive activation of the catalytic subunit of protein kinase A (PRKACA). By doing new in-depth analysis of their cytogenetic abnormality, we attempted a better genotype–phenotype correlation of theirPRKACAamplification.DesignThis study is a case series.MethodsMolecular cytogenetic, genomic, clinical, and histopathological analyses were performed in five patients with CS.ResultsReinvestigation of the defects of previously described patients by state-of-the-art molecular cytogenetics showed complex genomic rearrangements in the chromosome 19p13.2p13.12 locus, resulting in copy number gains encompassing the entirePRKACAgene; three patients (one sporadic case and two related cases) were observed with gains consistent with duplications, while two sporadic patients were observed with gains consistent with triplications. Although all five patients presented with ACTH-independent CS, the three sporadic patients had micronodular BAH and underwent bilateral adrenalectomy in early childhood, whereas the two related patients, a mother and a son, presented with macronodular BAH as adults. In at least one patient,PRKACAtriplication was associated with a more severe phenotype.ConclusionsConstitutional chromosomalPRKACAgene amplification is a recently identified genetic defect associated with CS, a trait that may be inherited in an autosomal dominant manner or occurde novo. Genomic rearrangements can be complex and can result in different copy number states of dosage-sensitive genes, e.g., duplication and triplication.PRKACAamplification can lead to variable phenotypes clinically and pathologically, both micro- and macro-nodular BAH, the latter of which we speculate may depend on the extent of amplification.

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.

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