Bilateral Post-typhoid Retinitis: A Case Report

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Kumudini Subedi ◽  
Smita Shrestha ◽  
Anu Manandhar
Keyword(s):  
Typhoid Fever ◽  
Enteric Fever ◽  
Visual Outcome ◽  
Oral Steroid ◽  
Fundus Examination ◽  
Progressive Loss ◽  
Immune Mediated ◽  
Good Visual Outcome ◽  
Oral Steroids ◽  
Retinal Haemorrhages

Retinitis following typhoid fever is an immune-mediated reaction that is rarely reported in literature. We present a case of a 20-year-old pregnant female who presented with progressive loss of vision in both eyes for three weeks. She had completed treatment for enteric fever 4 weeks before. Presenting vision was 6/36 in right eye and 3/60 in left eye. Fundus examination showed retinitis with retinal haemorrhages and macular stars in both eyes. After approval from gynaecologist, oral steroid was given. Vision improved significantly to 6/6 in right eye and 6/12 in left eye after 1.5 months of treatment. There was resolution of haemorrhages, exudates and stellate maculopathy. Hence, post-typhoid immune-mediated retinitis is rare sequelae of typhoid fever which can be treated with good visual outcome using oral steroids.

scholarly journals STEROID PULSE THERAPY IN SEVERE SYMPATHETIC OPHTHALMITIS – A CASE SERIES OF 4 PATIENTS

2020 ◽  
pp. 1-2
Author(s):  
Deepali Gogoi ◽  
Abhijit Kumar Handique ◽  
Indira Pegu
Keyword(s):  
Case Series ◽  
Visual Outcome ◽  
Pulse Therapy ◽  
Steroid Pulse Therapy ◽  
Oral Steroid ◽  
Steroid Pulse ◽  
Methyl Prednisolone ◽  
Immune Mediated ◽  
Sympathetic Ophthalmitis ◽  
Close Observation

Sympathetic ophthalmitis (SO) is a rare bilateral, granulomatous uveitis that occurs following surgical or accidental trauma to one eye. Injured eye is the Exciting eye and the fellow eye is the Sympathizing eye. Most accepted patho-physiology is immune mediated. In this series, 4 patients with varied presentations were started on steroid pulse therapy (SPT) following routine blood investigation. 1 gram i.v methyl-prednisolone was given on 3 consecutive days in 300 ml Normal Saline under close observation. The patients were then shifted to oral steroid which was gradually tapered over 11 days. The patients were followed up for a minimum period of 14 days and the visual outcome was recorded.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

Rubeosis iridis and macular hemorrhages from multiple Corkscrew retinal vessels in a patient with NF1

2021 ◽  
pp. 112067212199663
Author(s):  
Marilyn A Márquez ◽  
Claudio P Juárez ◽  
Maria C Sánchez ◽  
Jose D Luna
Keyword(s):  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Neovascular Glaucoma ◽  
Retinal Vessels ◽  
Retinal Hemorrhages ◽  
Fluorescein Angiogram ◽  
Rubeosis Iridis ◽  
Good Visual Outcome ◽  
Av Malformation ◽  
Sudden Decrease

Purpose: To report a case of a patient with NF1 presenting with ocular findings of AV malformation, multiple retinal hemorrhages, and neovascular glaucoma in the absence of retinal ischemia. Methods: Review of the medical record was conducted in accordance with the local IRBt. Results: A 60-year-old female patient with diagnosis of Neurofibromatosis type1 (NF1) and sudden decrease of vision in her left eye was found to have rubeosis iridis and high intraocular pressure (IOP). On fundus exam multiple corkscrew retinal vessels and retinal hemorrhages were present in her left eye. On Optical Coherence Tomography (OCT) the foveal hemorrhages appeared as outer layer hyperreflective retinal infiltrates whereas in the parafoveal area the hyperreflectivity was present between the RPE and neurosensory retina. Fluorescein Angiogram (FA) showed normal perfusion and no areas of leakage or ischemia. Treatment with anti-angiogenics in a timely manner correlated with a good visual outcome. Conclusions: We present a unique patient with NF1, rubeosis iridis, high IOP, and macular hemorrhages from multiple corkscrew retinal vessels in a well perfused retina, who underwent treatment with a single dose of intravitreal Bevacizumab and had an excellent response

scholarly journals Immune-inflammatory concept of the pathogenesis of chronic heart failure in dogs with dilated cardiomyopathy

2019 ◽  
Vol 12 (9) ◽  
pp. 1491-1498 ◽  
Author(s):  
Yu Vatnikov ◽  
A. Rudenko ◽  
P. Rudenko ◽  
Ev Kulikov ◽  
A. Karamyan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Dilated Cardiomyopathy ◽  
Internal Organs ◽  
Clinically Normal ◽  
Progressive Loss ◽  
Intestinal Dysbiosis ◽  
Immune Mediated ◽  
Functional Classes ◽  
Neurohumoral System

Background: Dilated cardiomyopathy is common in dogs. This form of cardiomyopathy is the main cause of death due to heart disease in dogs. Death can occur suddenly in clinically normal animals as a result of the progression of congestive heart failure (CHF). The pathogenesis of heart failure syndrome in dogs with dilated cardiomyopathy involves activation of the neurohumoral system and immune-mediated inflammation, which leads to further progression of the condition. Heart failure syndrome in dogs with dilated cardiomyopathy is caused by the progressive loss of cardiomyocytes, apoptosis, remodeling of the left ventricle, systolic and diastolic dysfunction, arrhythmias, reduced cerebral blood flow, the involvement of other key internal organs, and intestinal dysbiosis. Aim: This study aimed to determine the immunological and inflammatory mechanisms surrounding the development of heart failure syndrome in dogs with dilated cardiomyopathy. Materials and Methods: The subjects of this study were dogs with a dilated form of cardiomyopathy (n=159), complicated by various functional classes of heart failure syndrome. Evaluation of myocardial remodeling, systolic function, and systemic hemodynamics was performed using EMP-860 Vet and PU-2200V ultrasound scanners according to the standard technique. Electrocardiography was performed with all dogs in right lateral recumbency using the EK1T-04 Midas electrocardiograph (50 mm/s speed and 1 mV gain = 1 cm). Results: In some affected animals, especially in cases of compensated dilated cardiomyopathy, leukocytosis was noted. In patients with dilated cardiomyopathy complicated by heart failure syndrome of various functional classes, the number of neutrophils was significantly increased, and the number of lymphocytes was decreased by 1.9-2.1 times when compared with those in clinically normal animals. In dogs with dilated cardiomyopathy, neutrophilic leukocytosis develops with a simple regenerative shift to the left. The results of immunological studies indicate that dogs with dilated cardiomyopathy develop T lymphocytopenia as compared with clinically normal animals. Conclusion: The central component of heart failure syndrome in dogs with dilated cardiomyopathy is the activation of the neurohumoral system and immune-mediated inflammation. The development of CHF in dogs with dilated cardiomyopathy is caused by the progressive loss of cardiomyocytes, apoptosis, remodeling of the left ventricle, systolic and diastolic dysfunction, arrhythmias, reduced cerebral blood flow, involvement of other key internal organs, and intestinal dysbiosis.

Use of Inhaled Corticosteroids or Oral Steroids in a COVID-19 Telemedicine Cohort: Retrospective Chart Review (Preprint)

2021 ◽  
Author(s):  
Michele Cellai
Keyword(s):  
Chart Review ◽  
Inhaled Corticosteroids ◽  
Symptom Relief ◽  
Retrospective Chart Review ◽  
Oral Steroid ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Persistent Symptoms ◽  
Oral Steroids

BACKGROUND We identified patients with coronavirus disease 2019 that were followed by a telemedicine clinic and eventually referred to a post COVID clinic due to persistent symptoms of COVID-19. Of those patients requiring referral to the post COVID clinic, equal percentages of patients treated acutely with inhaled corticosteroids (ICS) and/ or oral steroids required referral to a pulmonary specialist. OBJECTIVE To determine if there was a difference in long term outcomes when prescribed ICS versus oral steroids METHODS Chart review comparing new prescription ICS to new prescription oral steroid RESULTS No difference in long term outcome between the groups CONCLUSIONS It is safe to prescribe ICS or oral steroids for symptom relief, but cost may be an issue

TYPHOID FEVER 002.0 (Enteric Fever)

2008 ◽  
pp. 92-94
Author(s):  
Theodore H. Curtis ◽  
David T. Wheeler
Keyword(s):  
Typhoid Fever ◽  
Enteric Fever

scholarly journals Drug-Resistant Salmonella typhi in Pakistan

2019 ◽  
Vol 59 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Christine E. Petrin ◽  
Russell W. Steele ◽  
Elizabeth A. Margolis ◽  
Justin M. Rabon ◽  
Holly Martin ◽  
...  
Keyword(s):  
United States ◽  
Typhoid Fever ◽  
Enteric Fever ◽  
The United States ◽  
Salmonella Typhi ◽  
Antimicrobial Treatment ◽  
Third Generation ◽  
Drug Resistant ◽  
Oral Transmission ◽  
Third Generation Cephalosporins

Enteric fever (formerly typhoid fever) is a bacterial illness caused by fecal-oral transmission of Salmonella typhi or paratyphi. In early 2018, an outbreak of Salmonella typhi resistant to third-generation cephalosporins, ampicillin, ciprofloxacin, trimethroprim-sulfamethoxazole, and chloramphenicol was reported in Pakistan. This strain, termed “extensively resistant typhi,” has infected more than 5000 patients in endemic areas of South Asia, as well as travelers to and from these areas, including 5 cases in the United States. We present the case of one such child who developed extensively resistant enteric fever during a recent visit to Pakistan and required broader antimicrobial treatment than typically required. Clinicians should be aware that incoming cases of enteric fever may be nonsusceptible to commonly recommended antibiotics and that extensively resistant typhi requires treatment with carbapenems such as meropenem or azithromycin.

scholarly journals Acute Disseminated Encephalomyelitis Following Typhoid Fever: A Case Report

2014 ◽  
Vol 9 (4) ◽  
pp. 55-58
Author(s):  
R Adhikari ◽  
A Tayal ◽  
PK Chhetri ◽  
B Pokhrel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Typhoid Fever ◽  
Demyelinating Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Medical Sciences ◽  
Cerebellar Syndrome ◽  
Immune Mediated ◽  
The Central Nervous System

The involvement of central nervous system in children with typhoid fever is common. Acute disseminated encephalomyelitis is a rare immune mediated and demyelinating disease of the central nervous system that usually affects children. We report a 7-year-old child with typhoid fever who developed acute cerebellar syndrome due to acute disseminated encephalomyelitis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 55-58 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10237

Refractive and Visual Outcomes after Scleral Fixated Intraocular Lens Implantation in Children with Ectopia Lentis

2020 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Regina Lalramhluni ◽  
Soveeta Rath ◽  
Ankita Shrivastav ◽  
Prem Kumar Singh ◽  
Rahul Mayor ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Visual Outcome ◽  
Ectopia Lentis ◽  
Corrected Visual Acuity ◽  
Good Visual Outcome ◽  
Induced Astigmatism ◽  
The Mean ◽  
The Stability ◽  
Scleral Fixated Intraocular Lens

Introduction: This study was conducted to report the refractive and visual outcome after Scleral Fixated Intraocular Lens (SFIOL) implantation in children with nontraumatic ectopia lentis. Methods: Retrospective review of the medical records of 25 eyes of 15 patients who underwent SFIOL implantation in children with non-traumatic ectopia lentis. Results: The mean best corrected visual acuity (BCVA) before SFIOL implantation was 1.07 ± 0.9 logMar units [median: 0.9, Interquartile range (ΙQR): 0.415 to 1.555] which improved to 0.41 ± 0.33 logMar units (median: 0.22, ΙQR: 0.180 to 1.555) at two months postoperative follow up. In phakic group, the mean spherical refraction preoperatively was -12.04 ± 7.82 DS (dioptre sphere) (IQR: +16 to -5.875) and postoperatively was +0.93 ± 2.67DS (IQR: -0.375 to +2). In aphakic group, the mean spherical refraction preoperatively was +12.22 ± 2.05 DS and postoperatively was +1.2 ± 1.9 DS. The mean total astigmatism preoperatively was -6.44 ± 4.95 DC (dioptre cylinder) (median: 6, IQR: -10.50 to +2) and postoperatively was -1.47 ± 0.98 DC (median: -1.5, IQR: -2 to - 0.625 ). The mean IOL induced astigmatism was -1.01 ± 0.95 DC (median -0.75, IQR: -1.33 to - 0.25). The spherical refractive equivalent was within 2 Diopter (D) of the target refraction calculated preoperatively in 20 eyes and in five eyes it was more than 2 D. Conclusion: SFIOL implantation is associated with good visual outcome with a significant improvement in the refractive error. However, a longer follow up is required to assess the change of refraction and the stability of the SFIOL.

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