Clinical case of fungal uveitis in a patient who underwent COVID-19

Author(s):  
A.V. Tereshchenko ◽  
◽  
I.G. Trifanenkova ◽  
Y.L. Ilina ◽  
N.N. Yudina ◽  
...  

Purpose. To analyze a clinical case of fungal uveitis in a patient who has undergone COVID-19. Material and methods. A patient born in 1962 was admitted to the Kaluga branch of the MNTK with complains of blurred vision. From the anamnesis: in the first half of 2020, he was treated at the Kaluga branch of the MNTK with a diagnosis of complicated cataract, highly complicated myopia, PCRD, CCRD, pigmentary glaucoma; in the autumn of 2020, he suffered a coronavirus infection complicated by severe bilateral interstitial pneumonia, he was in the intensive care unit for 2 weeks. Results. During examination of the patient, the clinical picture and data of objective methods indicated the development of bilateral uveitis in the patient. A course of anti-inflammatory therapy was prescribed, and positive dynamics were achieved. But there was a sharp deterioration on the 10th day. Concilium was held: a fungal etiology of uveitis was suspected. The anterior chamber was washed, material from the anterior chamber was taken for bacterial culture. At the 3rd day the results of bacterial culture showed the growth of Candida albicans fungi. A multistage complex medical and surgical treatment was carried out. The outcome is encouraged however, the observation time is insufficient to draw final conclusions. Conclusion. The incidence of COVID-19 remains high, so ophthalmologists should remain vigilant, collect a careful anamnesis and expect an increase of the number of patients with intraocular fungal infection. Key words: uveitis; fungal infection; COVID-19.

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.


Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.


2019 ◽  
Vol 12 (12) ◽  
pp. e233128
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon ◽  
Neha Mithal

A 38-year-old patient presented to us with complaints of blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/400, improving to 20/60 with pinhole. The patient underwent phakic iris-claw lens surgery 15 years ago for high myopia. On examination, there was anterior chamber rigid phakic iris-claw lens along with complicated cataract. We planned for sutureless self-sealing 6.5 mm sclerocorneal tunnel for explantation of rigid phakic iris-claw lens along with cataract extraction with irrigating vectis. There was postoperative reduction in astigmatism due to incision planned on steep axis, and visual acuity improved to 20/30 uncorrected. This technique provides significant advantages from the previously described techniques in terms of decreased postop astigmatism, no need for sutures, no issues of chamber instability and iris trauma and without the need for phacoemulsification.


2020 ◽  
Vol 10 (4) ◽  
pp. 301-307
Author(s):  
Ekaterina V. Kul’chavenya ◽  
Denis P. Kholtobin ◽  
Alexander I. Neymark

Introduction. In March 2020, the World Health Organization declared the outbreak of the novel coronavirus infection (COVID-19) a pandemic. The pandemic also significantly affected all academic, scientific and educational activities. Material and methods. We compared the work of the urological departments of the private (Medical Center Avicenna, Novosibisk) and municipal (City Clinical Hospital No. 11, Barnaul) clinics, as well as the urogenital department of the Novosibirsk Research Institute of Tuberculosis of the Ministry of Healthcare of Russia for 6 months of calm 2019, and the first half of 2020, which coincided with the start of the COVID-19 coronavirus pandemic. Results. In March 2020, the urogenital department of the Novosibirsk Research Institute of Tuberculosis of the Ministry of Healthcare of Russia was redesigned into an observational one. In the first half of 2020, patients with malignant neoplasms, varicocele, chronic pyelonephritis, hydronephrosis, dropsy of the testicular membranes and with phimosis/paraphimosis were admitted to the urology department of the City Hospital No. 11 in Barnaul in the first half of 2020. On the contrary, statistically significant in 2020 the number of patients admitted for kidney abscess and acute prostatitis prevailed. It can be assumed that, due to the tense epidemic situation, patients postponed seeking medical attention until their condition required emergency intervention. In the Medical Center Avicenna (Novosibirsk) in the first half of 2020 the number of visits to the pediatric urologist significantly decreased, the inpatient and average bed-day decreased. On the contrary the total duration of the patients' stay in the day hospital has significantly increased, which is logically explained by the epidemic situation; there was a statistically significant decrease in the number of most operations and outpatient procedures. Conclusion. The new coronavirus infection has affected all spheres of human life, to a maximum extent on medicine. In the first six months, no unified approaches to the management of urological patients in epidemic conditions were developed; clinics worked according to internal standards. Our analysis showed that strict adherence to sanitary and hygienic standards and the implementation of anti-epidemic measures allows us to provide urological care to patients in full-even in such unfavorable conditions.


2021 ◽  
Vol 9_2021 ◽  
pp. 232-236
Author(s):  
Shklyaev A.E. Shklyaev A ◽  
Bessonov A.G. Bessonov A ◽  
Chushyalova D.A. Chushyalova D ◽  
Mikhailova M.D. Mikhailova M ◽  
Meleshkina M.V. Meleshkina M ◽  
...  

2021 ◽  
Vol 73 (2) ◽  
pp. 81-85
Author(s):  
I.M. Arestov ◽  
A.A. Anisochkin ◽  
O.I. Yudakov ◽  
E.A. Sukhareva

To provide dynamic monitoring of the treatment effectiveness in the case of patients with a new coronavirus infection, it is important to consider that simple and illustrative methods are needed. A clinical blood test is the first and mandatory patients’ examination. This article presents the analysis of the leukocyte formula parameters and the erythrocyte sedimentation rate (ESR) in COVID-19 patients before treatment and during the period from the 1st to the 15th day of standard treatment. Therefore, lymphocytopenia, neutrophilosis, and increased ESR were recorded upon the patients’ admission to the hospital. Statistically significant deviations were manifested on the 10th day of treatment in the absolute WBC count increase in the case of existing leukopenia. During treatment, an increase in the number of patients with normal ESR, as well as a decrease in neutrophilosis, leukopenia and lymphopenia was observed, but no statistically significant differences were found.


2021 ◽  
pp. 129-132
Author(s):  
E. N. Alferovich ◽  
◽  
I. A. Loginova ◽  
A. A. Ustinovich ◽  
E. A. Sarzhevskaya ◽  
...  

The problem of coronavirus infection has captured the whole world. In one year, the views on the disease itself and its treatment have radically changed. Doctors all over the world cannot give definite answers to a number of questions regarding this virus and its impact on newborn babies. Low susceptibility to coronavirus in young children may be due to some peculiarities of the immune system. Today it is considered to be the main ways of transmission of the virus are airborne and contact. However, the airborne route of infection in newborns is unlikely, because from birth the child is isolated from the sick mother. The issue of the vertical transmission of the virus from an infected mother to a child is discussed. There is no evidence of transmission of coronavirus through breast milk. The diagnosis of coronavirus infection in children is established with a positive epidemiological history and with 2 clinical symptoms with laboratory confirmation. The article presents a single clinical case of coronavirus infection in a newborn. The possible ways of infection of the newborn, the clinical picture, the possibility of joint stay of the mother and the child, breastfeeding, and treatment of the newborn are discussed.


Vestnik ◽  
2021 ◽  
pp. 289-292
Author(s):  
Л.Ж. Алекешева ◽  
К.К. Тогузбаева ◽  
К.О. Джусупов

COVID-19 нанес серьезный удар по системам здравоохранения многих стран мира, включая Республику Казахстан. Чтобы справиться с пандемией, Казахстан разработал план, содержащий три стратегические цели: 1) предотвращение вспышки болезни; 2) Обеспечение оптимального ухода для всех пациентов и 3) Сведение к минимуму воздействия пандемии на системы здравоохранения, социальные услуги и экономическую деятельность. Однако неравномерное распределение финансовых ресурсов по регионам, нерегулярное потребление медицинских услуг и различия в показателях здоровья препятствуют этим усилиям. Другие проблемы - это нехватка медицинских сил, неожиданность ситуации, отсутствие знаний о коронавирусной инфекции и бессилие перед этой новой болезнью. Были трудности с массовым тестированием, поскольку стигма и страх перед карантином вынуждали людей не проходить тестирование. После отмены чрезвычайного положения и строгой изоляции страну охватила эйфория, которая привела к резкому увеличению числа случаев заболевания. Чтобы взять ситуацию под контроль в июне 2020 года был экстренно введен второй локдаун, постепенно стало уменьшаться количество больных и инфицированных. Пандемия показала, насколько хрупка и зависима система: была отложена плановая вакцинация детям до 1 года, временно приостановлено медицинское обследование и оказание медицинских услуг больным хроническими, онкологическими заболеваниями, плановая госпитализация. Многие врачи и медсестры заразились и заболели. На момент написания этой статьи эпидемиологическая ситуация в стране с COVID-19 находится под контролем и надзором, однако давать какие-либо прогнозы относительно его завершения пока рано. Казахстан готовится к вакцинации от коронавирусной инфекции, в первую очередь вакцинации должны подвергаться группы риска, медицинские и социальные работники, а также люди с хроническими заболеваниями. Пока коллективный иммунитет не сформирован, казахстанцы должны проявлять осторожность при снятии ограничений, чтобы предотвратить взрыв новых случаев заболевания. COVID-19 has strained the healthcare systems of many countries worldwide including the Republic of Kazakhstan. To cope with the pandemic, Kazakhstan mounted a plan containing three strategic objectives: 1) Preventing the outbreak of the disease; 2) Ensuring optimal care for all patients, and 3) Minimizing the impact of the pandemic on health systems, social services, and economic activities. However, the uneven distribution of financial resources across regions, irregular consumption of medical services, and inconsistent health indicators hamper these efforts. Other issues are the lack of medical forces, the unexpectedness of the situation, lack of knowledge on coronavirus infection, and powerlessness in front of this new disease. There were difficulties in mass testing as stigma and fear from quarantine forced people not to get tested. The euphoria enveloped the country after abolishing the emergency state after an intense lockdown which resulted in increased cases. A second lockdown was urgently introduced in June 2020 to take control of the situation. The number of patients and those infected gradually began to decline. The pandemic showed the fragility and inter-dependence of the health system- planned vaccinations against many infectious diseases were postponed. Medical examination and provision of medical services to patients with chronic, oncological diseases, planned hospitalization were temporarily halted. Many doctors and nurses became infected and ill. The country's COVID-19 epidemiological situation is somewhat under the control and supervision as of this writing. However, to give any forecasts for its completion is still too early. Kazakhstan is preparing to vaccinate against coronavirus infection. First of all, risk groups, medical and social workers, and people with chronic diseases should be subject to vaccination. Until herd immunity is not formed, Kazakhstanis must keep caution when the restrictions are taken off to prevent an explosion of new disease cases.


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