scholarly journals Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective

2020 ◽  
Vol 9 (1) ◽  
pp. 74
Author(s):  
Tommaso Lupia ◽  
Silvia Corcione ◽  
Antonio Maria Fea ◽  
Michele Reibaldi ◽  
Matteo Fallico ◽  
...  
Keyword(s):  
Rare Complication ◽  
Latency Period ◽  
Antimicrobial Treatment ◽  
Ocular Infection ◽  
Ocular Tissues ◽  
Fungal Endophthalmitis ◽  
High Drug Concentration ◽  
Function Preservation ◽  
Exogenous Fungal Endophthalmitis ◽  
Penetrating Ocular Trauma

Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery. The usual latency period between intraocular inoculation and presentation of symptoms from fungal endophthalmitis is several weeks to months as delayed-onset endophthalmitis. Aspergillus spp., is the most common causative mould pathogen implicated in this ocular infection and early diagnosis and prompt antimicrobial treatment, concomitantly in most cases with expert surgical attention, reduce unfavorable complications and increase the possibility of eye function preservation. Topical, intravitreal and systemic antifungal molecules are the mainstay of a medical approach to the disease and azoles, polyenes and in particular cases echinocandins are the pharmacological classes most commonly used in clinical practice. This review discusses pharmacokinetics and pharmacodynamic of antifungal agents in their principal modes of administration with a focus on their ability to achieve high drug concentration in the vitreous and ocular tissues.

scholarly journals Experimental infection of sheep with visna/maedi virus via the conjunctival space

2008 ◽  
Vol 89 (6) ◽  
pp. 1329-1337 ◽  
Author(s):  
Heide Niesalla ◽  
Tom N. McNeilly ◽  
Margaret Ross ◽  
Susan M. Rhind ◽  
Gordon D. Harkiss
Keyword(s):  
Post Infection ◽  
Mononuclear Cells ◽  
Mediastinal Lymph Node ◽  
Ocular Tissue ◽  
Ocular Infection ◽  
Peripheral Blood Mononuclear ◽  
Ocular Tissues ◽  
Virus Dose ◽  
Low Levels ◽  
First Time

Experiments were performed to determine whether visna/maedi virus (VMV), a small ruminant lentivirus (SRLV), could infect sheep via ocular tissues. The EV1 strain of VMV was administered into the conjunctival space of uninfected sheep, and the animals monitored for the presence of provirus DNA and anti-VMV antibodies in blood. The results showed that provirus DNA appeared in peripheral blood mononuclear cells of all animals within a few weeks of receiving either 106 TCID50 or 103 TCID50 of VMV. Of the animals receiving the higher dose of virus via the conjunctival space, two seroconverted by 7 and 10 weeks post-infection, one seroconverted 8 months post-infection, and one had not seroconverted by 15 months post-infection. With the lower virus dose, the animals infected via the trachea seroconverted by 4 and 14 weeks, respectively. After ocular infection with this dose, one animal showed a transitory seroconversion with low levels of antibody, peaking at 2 weeks post-administration. The remaining three of the animals infected via the eyes did not seroconvert over a period of 13 months. At post-mortem, evidence for the presence of proviral DNA was obtained from ocular tissue, lungs or mediastinal lymph node in both groups of animals. Histological analysis of lung tissue from animals receiving the lower dose of virus showed the presence of early inflammatory lesions. The results thus show for the first time that transmission of VMV can occur via ocular tissues, suggesting that the conjunctival space may be an additional route of natural transmission.

Exogenous Fungal Endophthalmitis: An Analysis of Isolates and Susceptibilities to Antifungal Agents Over a 20-Year Period (1990–2010)

2015 ◽  
Vol 159 (2) ◽  
pp. 257-264.e1 ◽  
Author(s):  
Ruwan A. Silva ◽  
Jayanth Sridhar ◽  
Darlene Miller ◽  
Charles C. Wykoff ◽  
Harry W. Flynn
Keyword(s):  
Antifungal Agents ◽  
Fungal Endophthalmitis ◽  
Exogenous Fungal Endophthalmitis

scholarly journals Role of intravitreal dexamethasone in exogenous fungal endophthalmitis

Eye ◽  
1999 ◽  
Vol 13 (5) ◽  
pp. 660-665 ◽  
Author(s):  
Ajit B Majji ◽  
Subhadra Jalali ◽  
Taraprasad Das ◽  
Usha Gopinathan
Keyword(s):  
Fungal Endophthalmitis ◽  
Exogenous Fungal Endophthalmitis ◽  
Intravitreal Dexamethasone

scholarly journals Hyperparathyroidism Two Years after Radioactive Iodine Therapy in an Adolescent Male

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Danielle L. Gomez ◽  
Dorothy I. Shulman
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Primary Hyperparathyroidism ◽  
Radioactive Iodine ◽  
Rare Complication ◽  
Latency Period ◽  
Adolescent Male ◽  
Radioactive Iodine Therapy ◽  
Papillary Thyroid ◽  
Iodine Treatment

Primary hyperparathyroidism is a very rare complication following radioactive iodine therapy. There is typically a latency period of more than a decade following radiation exposure and, therefore, it is observed almost exclusively in adults. Consequently, pediatricians are not aware of the association. We present a case of primary hyperparathyroidism due to a solitary parathyroid adenoma occurring in an adolescent male two years following radioactive iodine treatment for papillary thyroid carcinoma. Periodic screening of serum calcium following ablative doses of radioactive iodine for thyroid cancer may be justified even in adolescents.

scholarly journals Acute fulminant necrotizing amebic colitis in a pediatric patient: a rare complication of amebiasis with high mortality—a case report

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Samantha Kiriwaththuduwa ◽  
Romola Gnanapragasam ◽  
Anjalie Amarasinghe ◽  
Yugantha Adikari ◽  
Shanika Ranasinghe ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Case Reports ◽  
Rare Complication ◽  
District General Hospital ◽  
Antimicrobial Treatment ◽  
Normal Diet ◽  
Health Concern ◽  
Case Presentation ◽  
Amebic Colitis ◽  
Polymerase Chain

Abstract Background The majority of amebic infections among humans remain asymptomatic. Rarely, the disease takes a fulminant acute course due to the development of necrotizing amebic colitis. This complication is usually found in adult patients. However, on the contrary, this case was diagnosed in a 9-year-old patient. He was transferred to the Sirimavo Bandaranayake Specialized Children’s Hospital (SBSCH), Peradeniya from the District General Hospital, Kilinochchi. To our knowledge, this is the first report of this rare complication in a child in Sri Lanka. Case presentation We present a case of acute fulminant necrotizing amebic colitis in a 9-year-old boy. Surgical exploration revealed extensive ulceration and multiple perforations in the entire colon. PAS-Martius Yellow 40 stain highlighted amebae with erythrophagocytosis within the necrotic debris of the ulcers. The polymerase chain reaction (PCR) that was conducted to confirm the diagnosis was positive for Entameba histolytica. The post-operative course was marked with antimicrobial treatment for septicemia and the need for ventilator assistance. Antimicrobial treatment included intravenous metronidazole. The patient progressively recovered and was discharged on a normal diet. Conclusion This case reports an acute fulminant necrotizing amebic colitis in a 9-year-old patient. After the treatments, the patient progressively recovered and was discharged on a normal diet. E. histolytica infections in northern Sri Lanka should be given attention as a public health concern. Furthermore, this case highlights that acute fulminant amebic colitis requires early surgical intervention, aggressive supportive and anti-amebic treatments. Clinicians should be cognizant of this potentially fatal complication of amebic colitis.

scholarly journals Viral S protein histochemistry reveals few potential SARS-CoV-2 entry sites in human ocular tissues

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gottfried Martin ◽  
Julian Wolf ◽  
Thabo Lapp ◽  
Hansjürgen T. Agostini ◽  
Günther Schlunck ◽  
...  
Keyword(s):  
Lung Tissue ◽  
Viral Entry ◽  
Ocular Tissue ◽  
Ocular Infection ◽  
Positive Staining ◽  
Lacrimal Glands ◽  
Ocular Tissues ◽  
Tissue Samples ◽  
S Protein ◽  
Disease States

AbstractDespite the reported low expression of the primary SARS-CoV-2 receptor ACE2 in distinct ocular tissues, some clinical evidence suggests that SARS-CoV-2 can infect the eye. In this study, we explored potential entry sites for SARS-CoV-2 by viral S protein histochemistry on various ocular tissues and compared the staining patterns with RNA and protein expression of TMPRSS2 and ACE2. Potential viral entry sites were investigated by histochemistry using tagged recombinant viral S protein on 52 ocular tissue samples including specimens of the cornea, conjunctiva, lid margin, lacrimal gland tissue, retina, choroid, and RPE. In addition, ACE2 and TMPRSS2 immunohistochemistry were performed on the same ocular tissue, each with distinct antibodies binding to different epitopes. Lung tissue samples were used as positive controls. Finally, bulk RNA sequencing (RNA-Seq) was used to determine the expression of ACE2 and its auxiliary factors in the tissues mentioned above. S protein histochemistry revealed a positive staining in lung tissue but absent staining in the cornea, the conjunctiva, eye lid samples, the lacrimal glands, the retina and the optic nerve which was supported by hardly any immunoreactivity for ACE2 and TMPRSS2 and scarce ACE2 and TMPRSS2 RNA expression. Negligible staining with antibodies targeting ACE2 or TMPRSS2 was seen in the main and accessory lacrimal glands. In contrast, ocular staining (S protein, ACE2, TMPRSS2) was distinctly present in pigmented cells of the RPE and choroid, as well as in the ciliary body and the iris stroma. S protein histochemistry revealed hardly any SARS-CoV-2 entry sites in all ocular tissues examined. Similarly, no significant ACE2 or TMPRSS2 expression was found in extra- and intraocular tissue. While this study suggest a rather low risk of ocular infection with SARS-CoV-2, it should be noted, that potential viral entry sites may increase in response to inflammation or in certain disease states.

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