Borrelia, Bartonella and Rickettsia Related Uveitis; Diagnosis and Management

2019 ◽  
pp. 300-304
Keyword(s):  
Systemic Disease ◽  
Clinical Findings ◽  
Diagnosis And Management ◽  
Arthropod Vectors ◽  
Ocular Manifestations ◽  
Prompt Diagnosis

Rickettsia and Borrelia are microorganisms that are transmitted to humans through a bite of arthropod vectors such as ticks, lice, fleas. Bartonella is often transmitted to humans by cat scratches or bites and causing systemic disease. Ocular manifestations may also accompany the systemic disease. These rare infections usually have a self-limiting course, but severe systemic and ophthalmic complications may also occur. Therefore, to be familiar with the clinical findings of these entities can facilitate prompt diagnosis and prevention of potential morbidities.

Diagnosis and management of hook of hamate fractures

2017 ◽  
Vol 43 (5) ◽  
pp. 539-545 ◽  
Author(s):  
Assaf Kadar ◽  
Allen T. Bishop ◽  
Marissa A. Suchyta ◽  
Steven L. Moran
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Clinical Findings ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
Historical Case ◽  
Treatment Groups ◽  
Diagnosis And Management ◽  
Time To Diagnosis ◽  
Hook Of Hamate

The purpose of this study was to evaluate the time to diagnosis and management of hook of hamate fractures in an era of advanced imaging. We performed a retrospective study of 51 patients treated for hook of hamate fractures. Patients were sent a quickDASH questionnaire regarding the outcomes of their treatment. Hook of hamate fractures were diagnosed with advanced imaging at a median of 27 days. Clinical findings of hook of hamate tenderness had better sensitivity than carpal tunnel-view radiographs. Nonunion occurred in 24% of patients with non-operative treatment and did not occur in the operative group. Both treatment groups achieved good clinical results, with a grip strength of 80% compared with the non-injured hand and a median quickDASH score of 2. Advanced imaging improved the time to diagnosis and treatment compared to historical case series. Nonunion is common in patients treated non-operatively. Level of evidence: IV

scholarly journals The clinical spectrum of ocular bartonellosis: a retrospective study at a tertiary centre in Malaysia

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Michele Shi-Ying Tey ◽  
Gayathri Govindasamy ◽  
Francesca Martina Vendargon
Keyword(s):  
Hand Movement ◽  
Clinical Findings ◽  
Common Finding ◽  
Final Visit ◽  
Ocular Involvement ◽  
Exudative Retinal Detachment ◽  
Tertiary Centre ◽  
Ocular Manifestations ◽  
Ocular Findings ◽  
Clinical Records

Abstract Background Cat scratch disease (CSD) is a systemic illness caused by the gram-negative bacillus, Bartonella henselea, which can occasionally involve the ocular structures. The objective of this study is to evaluate the various clinical presentations of ocular bartonellosis at our institution. A retrospective review of the clinical records of 13 patients (23 eyes) with ocular manifestations of Bartonella infections over a 3-year period between January 2016 to December 2018 was undertaken at our institution. Results The diagnosis was made based on clinical findings and in addition, with the support of the evidence of Bartonella hensalae IgG and/or IgM. Small retinal white lesions were the most common ocular findings in this series of patients (82.6% of eyes, 76.9% of patients). Neuroretinitis was the second most common finding (47.8% of eyes, 69.2% of patients), followed by exudative retinal detachment involving the macula (34.8% of eyes, 53.8% of patients) and Parinaud’s oculoglandular syndrome (17.4% of eyes, 23.1% of patients). Other findings like isolated optic disc oedema without macular star (8.7% of eyes, 15.4% of patients) and vitritis (4.3% of eyes, 7.7% of patients) were also observed. Ten patients (76.9%) had bilateral ocular involvement. Most of the patients were young, immunocompetent and had systemic symptoms like fever prior to their ocular symptoms. The visual acuity (VA) at initial presentation ranged from 6/6 to hand movement (mean, 6/20), and at final visit 6/6 to 6/60, (mean, 6/9). 91.7% of patients were treated with antibiotics. Only 2 patients received oral corticosteroids together with antibiotics due to very poor vision on presentation. The visual prognosis of ocular bartonellosis is generally good with 16 (88.9%) of 23 eyes having VA of 6/12 or better at final follow-up visit. Conclusion Small foci of retinal white lesions were the most common manifestation of ocular bartonellosis in this series, followed by neuroretinitis, though an array of other ocular findings may also occur. Therefore, we should consider bartonella infection as a possible differential diagnosis in those patients.

Four common diseases causing sudden blindness or death in the eye emergency department

2020 ◽  
pp. postgradmedj-2020-138163
Author(s):  
Ana Leonor Rei da Cruz Escaleira ◽  
Dimitrios Kalogeropoulos ◽  
Chris Kalogeropoulos ◽  
Soon Wai Ch’Ng ◽  
Velota C T Sung ◽  
...  
Keyword(s):  
Emergency Department ◽  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Ocular Motility ◽  
Ocular Manifestations ◽  
Ischaemic Attack ◽  
High Index Of Suspicion ◽  
Sudden Blindness ◽  
Patient At Risk ◽  
Prompt Diagnosis

Neuro-ophthalmological emergency disorders typically present with symptoms of visual loss, diplopia, ocular motility impairment or anisocoria. The ocular manifestations of these disorders are sometimes indicative of a more serious global neurology disease rather than an isolated ocular disease. The aim of this review is to highlight four important neuro-ophthalmological emergency disorders that must not be missed by an ophthalmologist. These include acute painful Horner’s syndrome, painful cranial nerve III palsy, giant cell arteritis and transient ischaemic attack with amaurosis fugax. The delayed diagnosis of these clinical entities puts the patient at risk of blindness or death. Therefore, prompt diagnosis and management of these conditions are essential. This can be acquired from understanding the main signs and symptoms of the disease presentation together with a high index of suspicion while working at a busy eye emergency department.

scholarly journals Varied Ophthalmic Presentations in Sphenoid Sinus Lesions

2011 ◽  
Vol 4 (1) ◽  
pp. 15-20
Author(s):  
RG Aiyer ◽  
Rahul Gupta ◽  
Prarthna S Dhameja ◽  
Virag Damania ◽  
Abhishek Sharma ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Fungal Infection ◽  
Sphenoid Sinus ◽  
Imaging Techniques ◽  
Accurate Diagnosis ◽  
Team Approach ◽  
Diagnosis And Management ◽  
Ocular Manifestations ◽  
Diagnostic Imaging Techniques

ABSTRACT Sphenoid sinus lesions can present with a multitude of symptoms/signs including ophthalmic disturbances. We describe a total of five patients, of which two had mucoceles and rest three had fungal infection. Ophthalmic symptoms/signs were the ones we were really interested in. We also present one case which had isolated sphenoid fungal sinus. We also give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.

scholarly journals Epidemiology of disease-activity related ophthalmological manifestations in Systemic Lupus Erythematosus: A systematic review

Lupus ◽  
2021 ◽  
pp. 096120332110503
Author(s):  
Nitish Jawahar ◽  
Jessica K Walker ◽  
Philip I Murray ◽  
Caroline Gordon ◽  
John A Reynolds
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Retinal Vasculitis ◽  
Small Sample ◽  
Systemic Lupus ◽  
Ocular Manifestations ◽  
Ophthalmic Manifestations

Objective Ophthalmic complications in Systemic Lupus Erythematosus (SLE) are broad and can occur in up to a third of patients. The British Isles Lupus Assessment Group (BILAG) 2004 Index identifies 13 ocular manifestations of active SLE, as opposed to those related to previous disease activity and/or the consequences of therapy. We conducted a systematic review of published literature to determine the frequency of ophthalmic manifestations of active SLE. Methods A systematic literature search of Ovid MEDLINE and EMBASE from their respective inceptions to July 2020 was conducted to identify cohort, case–control and cross-sectional studies. Results 22 studies meeting eligibility criteria were included. Most studies featured small sample sizes and were judged to have a high risk of methodological bias. The number and quality of studies did not allow us to confidently estimate the incidence of the conditions. No studies reported epidemiological data for orbital inflammation/myositis/proptosis. The prevalence of each of the other ocular manifestations, with the exception of retinal vaso-occlusive disease, was consistently less than 5%. Retinal vasculitis, uveitis and isolated cotton wool spots tended to be associated with more active SLE disease. Conclusion The prevalence of eye disease due to SLE activity is uncommon, but clinicians should be aware that some conditions tend to be associated with more active systemic disease. Further studies to determine the incidence and risk factors for these ophthalmic manifestations are needed.

Oral mucosal manifestations of systemic disease

2021 ◽  
pp. 175573802110451
Author(s):  
Rebecca Iles ◽  
Melanie Simms ◽  
Alistair Ledsam
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Oral Mucosa ◽  
Systemic Disease ◽  
Health Related Quality ◽  
Diagnosis And Management ◽  
Wide Range ◽  
Related Quality ◽  
Health Related

Disorders spanning a wide range of body systems may, directly or indirectly, impact upon the orofacial tissues. Specifically, the oral mucosa may be the first, or most severely affected site of systemic disease, posing significant implications for oral health-related quality of life. It is not uncommon for patients to present to their GP with orofacial symptoms, therefore a firm understanding of how systemic disease can manifest in this way is important. This article will discuss oral mucosal presentations of systemic disease, aiming to improve understanding and recognition of these conditions, allowing appropriate referral for investigation, diagnosis and management.

Sarcoidosis

2013 ◽  
pp. 1434-1441
Author(s):  
Joachim Müller-Quernheim ◽  
Gernot Zissel ◽  
Antje Prasse
Keyword(s):  
Tumour Necrosis ◽  
Systemic Disease ◽  
Organ Damage ◽  
Immunosuppressive Agent ◽  
Clinical Findings ◽  
Immunosuppressive Regimen ◽  
Cytokine Network ◽  
Symptomatic Disease ◽  
Resistant Disease ◽  
Necrosis Factor

Sarcoidosis is a systemic disease characterized by non-necrotizing granulomata and manifestations in almost any organ. Diagnosis relies on the exclusion of other granulomatous disorders and a compatible pattern of symptoms and clinical findings. Inflammatory lesions and granulomata may undergo spontaneous resolution or persist in chronic disease with eventual fibrosis and permanent organ damage. Immunological disease mechanisms are linked to severe derangements of the cytokine network. In systemic resolution or under prednisolone therapy of symptomatic disease pro-inflammatory cytokines are downregulated and histological lesions may completely vanish. Corticosteroid-resistant disease, however, requires treatment with an immunosuppressive regimen consisting of prednisolone and an immunosuppressive agent or anti-tumour necrosis factor (TNF) monoclonal antibodies.

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