scholarly journals Fungal Keratitis: Recent Advances in Diagnosis and Treatment

2021 ◽  
Author(s):  
Suwarna Suman ◽  
Arushi Kumar ◽  
Indu Saxena ◽  
Manoj Kumar
Keyword(s):  
Fungal Infections ◽  
Delayed Diagnosis ◽  
Fungal Keratitis ◽  
Diagnosis And Treatment ◽  
Bacterial Keratitis ◽  
Common Cause ◽  
Delay In Diagnosis ◽  
Recent Advances ◽  
Ocular Morbidity ◽  
Major Factors

Fungal keratitis or fungal corneal ulcer is potentially blinding infection of cornea, is considered one of the major cause of ocular morbidity, particularly in developing countries. It is a common cause of infectious keratitis, especially in tropical and subtropical countries. Fungal keratitis is notoriously challenging to diagnosis and difficult to treat. Delay in diagnosis may result in irreversible sequelae of corneal fungal infections, which can be preventable. Fungal keratitis often have worse treatment outcomes than bacterial keratitis, Delayed diagnosis and scarcity of effective antifungal agents are the major factors for poor outcome. In the recent years considerable advancement in the diagnosis and treatment has been occurred. In this chapter, we will discuss the recent advances in diagnosis and management of fungal keratitis with a brief discussion on pathogenesis and future therapeutic models.

Risk factors for the delayed diagnosis of extrapulmonary TB

2021 ◽  
Vol 25 (3) ◽  
pp. 191-198
Author(s):  
M. K. Lee ◽  
C. Moon ◽  
M. J. Lee ◽  
Y. G. Kwak ◽  
E. Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Diagnostic Testing ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Diagnosis And Treatment ◽  
Delay In Diagnosis ◽  
Microbiological Characteristics ◽  
Significant Difference ◽  
Basic Characteristics

BACKGROUND: Extrapulmonary TB (EPTB) is more difficult to diagnose than pulmonary TB. The delayed management of EPTB can lead to complications and increase the socio-economic burden.METHODS: Patients newly diagnosed with EPTB were retrospectively enrolled from 11 general hospitals in South Korea from January 2017 to December 2018. The basic characteristics of patients were described. Univariable and multivariable analyses were performed between early and delayed diagnosis groups to identify risk factors for delayed diagnosis and treatment in EPTB.RESULTS: In total, 594 patients were enrolled. Lymph node TB (28.3%) was the predominant form, followed by abdominal (18.4%) and disseminated TB (14.5%). Concurrent lung involvement was 17.8%. The positivity of diagnostic tests showed no significant difference between the two groups. Acute clinical manifestations in disseminated, pericardial and meningeal TB, and immunosuppression were associated with early diagnosis. Delayed diagnosis was associated with outpatient clinic visits, delayed sample acquisition and diagnostic departments other than infection or pulmonology.CONCLUSION: The delay in diagnosis and treatment of EPTB was not related to differences in microbiological characteristics of Mycobacterium tuberculosis itself; rather, it was due to the indolent clinical manifestations that cause referral to non-TB-specialised departments in the outpatient clinic and delay the suspicion of TB and diagnostic testing.

scholarly journals Fungal Keratitis: Epidemiology, Rapid Detection, and Antifungal Susceptibilities ofFusariumandAspergillusIsolates from Corneal Scrapings

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Palanisamy Manikandan ◽  
Ahmed Abdel-hadi ◽  
Yendrembam Randhir Babu Singh ◽  
Rajaraman Revathi ◽  
Raghavan Anita ◽  
...  
Keyword(s):  
Rapid Detection ◽  
Corneal Ulcer ◽  
Fungal Keratitis ◽  
Mycotic Keratitis ◽  
Common Cause ◽  
Epidemiological Trend ◽  
Male Preponderance ◽  
The Common ◽  
Ocular Morbidity ◽  
Culture Positive

Fungal aetiology of keratitis/corneal ulcer is considered to be one of the leading causes of ocular morbidity, particularly in developing countries including India. More importantly,FusariumandAspergillusare reported commonly implicating corneal ulcer and against this background the present work was undertaken so as to understand the current epidemiological trend of the two fungal keratitis. During the project period, a total of 500 corneal scrapings were collected from suspected mycotic keratitis patients, of which 411 (82.2%) were culture positive for bacteria, fungi, and parasites. Among fungal aetiologies,Fusarium(216, 52.5% of 411) andAspergillus(68, 16.5% of 411) were predominantly determined. While the study revealed a male preponderance with both the fungal keratitis , it further brought out that polyene compounds (natamycin and amphotericin B) and azoles were active, respectively, againstFusariumspp. andAspergillusspp. Additionally, 94.1% of culture provenFusariumkeratitis and, respectively, 100% and 63.6% ofA. flavusandA. fumigatuswere confirmed by multiplex PCR. The sensitivity of the PCR employed in the present study was noted to be 10 fg/μl, 1 pg/μl, and 300 pg/μl of DNA, respectively, forFusarium,A. flavus,andA. fumigatus.Alarming fact was thatFusariumandAspergillusregionally remained to be the common cause of mycotic keratitis and theFusariumisolates had a higher antifungal resistance thanAspergillusstrains against most of the test drugs.

Delay in Diagnosis: Indeterminate Leprosy Presenting with Rheumatic Manifestations

2000 ◽  
Vol 4 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Parrish Sadeghi ◽  
Marsha Dupree ◽  
J. Andrew Carlson
Keyword(s):  
Differential Diagnosis ◽  
Delayed Diagnosis ◽  
Lepromatous Leprosy ◽  
Clinical Suspicion ◽  
Accurate Diagnosis ◽  
Diagnosis And Treatment ◽  
Cutaneous Manifestations ◽  
Hansen's Disease ◽  
Delay In Diagnosis ◽  
Rheumatic Manifestations

Background: Rheumatic complications are common in leprosy (Hansen's disease) and can be the primary complaint delaying accurate diagnosis. Objective: Such a case is reported here: a 61-year-old woman with indeterminate leprosy presented with symmetric arthritis and purpura. Despite biopsy and evaluation by several physicians, leprosy was not suspected. After 2 years of progressive symptoms, a second biopsy revealed lepromatous leprosy. Conclusion: In this case, lack of clinical suspicion and unfamiliarity with the histology of indeterminate leprosy delayed diagnosis and treatment. Leprosy should be considered in the differential diagnosis of patients presenting with unusual rheumatic and persistent cutaneous manifestations.

scholarly journals Incidence of fungal keratitis in Libya: An epidemiological study

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Ahmed Atia ◽  
Abdulsalam Ashour ◽  
Hanan Alfaigh
Keyword(s):  
Candida Albicans ◽  
Early Diagnosis ◽  
Fungal Infection ◽  
Epidemiological Study ◽  
Culture Media ◽  
Fungal Infections ◽  
Fungal Keratitis ◽  
Ocular Infections ◽  
Ocular Morbidity ◽  
Media Data

Objectives: The aim of this study was to assess the occurrence of eye fungal infection among patients attending the eye hospital in Tripoli city, Libya. Materials and Methods: Seventy-one patients with ocular fungal infections were subjected to clinical and microbiological investigations. They were selected from patients attending the Tripoli Eye Hospital. The specimens of the external ocular infections were collected using sterile swab and inoculated to different culture media. Data were presented as count and percentages. Results: The current findings showed that Aspergillus was the most common causative agent, being responsible for 91.54% of the all cases, followed by Candida albicans (8.46%). Conclusion: Occurrence of fungal keratitis gradually increased in the years after 2009, especially after 2013. Knowledge of the pathological course and clinical features of fungal keratitis will undoubtedly bead in early diagnosis and treatment, with reduction in ocular morbidity.

scholarly journals Fungal keratitis: study of increasing trend and common determinants

2017 ◽  
Vol 7 (2) ◽  
pp. 685-693 ◽  
Author(s):  
Yogesh Acharya ◽  
Bhawana Acharya ◽  
Priyanka Karki
Keyword(s):  
Early Diagnosis ◽  
Management Strategy ◽  
Clinical Course ◽  
Fungal Keratitis ◽  
Diagnosis And Treatment ◽  
Effective Control ◽  
Clinical Challenge ◽  
Increasing Trend ◽  
Ocular Morbidity ◽  
Control Knowledge

Fungal keratitis is one of the leading cause of ocular morbidity. Fungal keratitis possesses a clinical challenge due to its slow pathologic process, overlapping features, diagnostic difficulty, and potential complications. Its increasing trend can be attributed to the use of contact lens, non-judiciary corticosteroid, and vegetative trauma. Early diagnosis and treatment is the cornerstone for its effective control. Knowledge of pathological course and clinical characteristics of fungal keratitis will definitely add in early diagnosis and treatment, with reduction in ocular morbidity. This review article explores the risk factor of fungal keratitis, its clinical course and management strategy.

scholarly journals Younger age of onset and uveitis associated with HLA-B27 and delayed diagnosis in Thai patients with axial spondyloarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naphruet Limsakul ◽  
Praveena Chiowchanwisawakit ◽  
Parichart Permpikul ◽  
Yubolrat Thanaketpaisarn
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Delayed Diagnosis ◽  
Musculoskeletal Symptom ◽  
Hla B27 ◽  
Delay In Diagnosis ◽  
Factors Associated ◽  
Younger Age

AbstractTo identify characteristics associated with HLA-B27, and to identify factors associated with delayed diagnosis in Thai patients with axial spondyloarthritis (axSpA). This cross-sectional study included Thai patients were diagnosed with axSpA by a rheumatologist at Siriraj Hospital. Clinical data were collected. Regression analyses were employed to identify factors associated with study outcomes. Of total 177 patients, 127 (72%) were positive HLA-B27. Uveitis [Odds ratio (OR) 4.0], age at onset of the first musculoskeletal symptom of ≤ 28 years [OR 3.5], female [OR 0.4], and psoriasis [OR 0.4] were significantly associated with HLA-B27 in multiple regression analysis. Those with positive HLA-B27 had less spinal flexibility. Elevated C-reactive protein (p = 0.012) was associated with shorter delay in diagnosis, while uveitis (p < 0.001) and younger age at onset of the first symptom (p = 0.002) were associated with longer delay in diagnosis in multiple regression analysis. Younger age at onset of the first musculoskeletal symptom and uveitis were associated with HLA-B27 and delayed diagnosis in axSpA patients. Young people with musculoskeletal symptom and uveitis should be referred to a rheumatologist to rule out or make a timely diagnosis of axSpA.

scholarly journals Educational aspects of rare and orphan lung diseases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tiago M. Alfaro ◽  
Marlies S. Wijsenbeek ◽  
Pippa Powell ◽  
Daiana Stolz ◽  
John R. Hurst ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Delayed Diagnosis ◽  
Reference Network ◽  
Delay In Diagnosis ◽  
Positive Effects ◽  
European Reference Network ◽  
Patient Representatives ◽  
Rare Lung Diseases

AbstractPeople with rare lung diseases often suffer the burden of delayed diagnosis, limited treatment options, and difficulties in finding expert physicians. One of the reasons for the delay in diagnosis is the limited training for healthcare practitioners on rare diseases. This review explores the main concerns and needs for education on rare lung diseases from the perspectives of both patients and professionals. Despite the increasing interest in rare lung disorders and some recent breakthrough developments on the management of several diseases, healthcare professionals, including general practitioners and hospital workers, receive little education on this topic. Nonetheless, many healthcare professionals show much interest in receiving further training, especially on diagnosis. Patients and families want easier access to high-quality education materials to help them manage their own disease. Well-educated patients are better equipped to deal with chronic diseases, but patient education can be challenging as patients’ individual health issues, and diverse backgrounds can create significant barriers. Raising more awareness for rare lung diseases and further development of patient-centred international expert networks like the European Reference Network on Rare Lung Diseases (ERN-LUNG), which includes both experts and patient representatives, are essential for improving care and education on rare lung diseases. Initiatives such as the Rare Disease Day, have been successful in increasing awareness for rare conditions. The development of online tools for accessing information has had positive effects and should be further supported and extended in the future.

scholarly journals GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 493
Author(s):  
Riccardo Di Fiore ◽  
Sherif Suleiman ◽  
Bridget Ellul ◽  
Sharon A. O’Toole ◽  
Charles Savona-Ventura ◽  
...  
Keyword(s):  
Cancer Research ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Delayed Diagnosis ◽  
Research Programme ◽  
Basic Research ◽  
Diagnosis And Treatment ◽  
Rare Cancer ◽  
Cost Action ◽  
Gynecologic Tumors

More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state-of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide.

Sign in / Sign up

Export Citation Format

Share Document