RESUMO
A 40-year old female chimpanzee (Pan troglodytes) developed hyporexia, weight loss, followed by progressive and complete blindness. Tomography demonstrated an intracranial mass in the rostroventral brain involving the optic chiasm, with a presumptive diagnosis of neoplasm. However, histopathology revealed a granulomatous meningoencephalitis, and tissue samples tested positive for Mycobacterium tuberculosis.
Assuntos
Doenças dos Símios Antropoides , Cegueira , Meningoencefalite , Mycobacterium tuberculosis , Pan troglodytes , Animais , Feminino , Doenças dos Símios Antropoides/diagnóstico , Doenças dos Símios Antropoides/microbiologia , Doenças dos Símios Antropoides/patologia , Mycobacterium tuberculosis/isolamento & purificação , Cegueira/veterinária , Cegueira/etiologia , Cegueira/microbiologia , Cegueira/diagnóstico , Meningoencefalite/veterinária , Meningoencefalite/microbiologia , Meningoencefalite/diagnóstico , Granuloma/veterinária , Granuloma/microbiologia , Granuloma/patologia , Granuloma/diagnóstico , Tuberculose/veterinária , Tuberculose/diagnóstico , Tuberculose/complicaçõesRESUMO
This study aims to report a rare instance of corneal decompensation brought on by Coniochaeta hoffmannii fungus invasion of a bandage contact lens (BCL). A 71-year-old man with pseudophakic bullous keratopathy (PBK) had BCL treatment for four months to symptomatically reduce pain and itching in his right eye. However, the patient unexpectedly lost his vision. The slit-lamp examination revealed an edematous cornea; the extensive direct inspection raised suspicion of BCL. For morphological characterization, the BCL extracted was inoculated onto 5% sheep blood agar and PDA. By Sanger sequencing method the isolate's genomic DNA was molecularly identified as C. hoffmannii.
Assuntos
Ascomicetos , Bandagens , Lentes de Contato Hidrofílicas , Micoses , Idoso , Humanos , Masculino , Ascomicetos/isolamento & purificação , Ascomicetos/patogenicidade , Bandagens/microbiologia , Cegueira/etiologia , Cegueira/microbiologia , Lentes de Contato Hidrofílicas/microbiologia , Ceratite/etiologia , Ceratite/microbiologia , Manejo da Dor , Prurido/terapia , Micoses/etiologia , Micoses/microbiologiaRESUMO
OBJECTIVE: To describe common bacterial organisms cultured from retrobulbar cellulitis and abscess lesions, in vitro susceptibility patterns, common diagnostic techniques utilized, etiologies encountered, and prevalence of blindness. ANIMALS STUDIED: Thirty-eight dogs diagnosed with retrobulbar cellulitis or abscessation from 2007 to 2017. PROCEDURE: For cases of orbital cellulitis or abscess, signalment, orbital imaging, cytology, histopathology, bacterial culture and susceptibility testing, presence of vision at the initial examination and resolution, and presumed cellulitis/abscess etiology were recorded. RESULTS: Most cases were medically (78.9%) versus surgically managed (18.4%). Most common form of orbital imaging was computed tomography (48.5%) followed by ocular ultrasound (18.2%). Fifteen of eighteen cultures (83.3%) showed growth of aerobic bacterial organisms, anaerobic bacterial organisms, or both. Most common aerobic bacteria were gram-negative bacilli (40.0%) followed by Corynebacterium sp. (26.7%) and α-hemolytic Streptococci sp. (26.7%) but Micrococcus and Bacillus spp. were also identified. Most common anaerobic bacteria were gram-negative bacilli (40.0%). Antibiotics with highest susceptibility patterns included gentamicin, followed equally by amoxicillin/clavulanic acid, cephalothin, chloramphenicol, and imipenem. No bacteria were susceptible to cefovecin. Six cases presented with vision loss due to retrobulbar disease (15.8%). Idiopathic (50%) disease and tooth root abscessation (23.7%) were most commonly diagnosed cause of orbital disease. CONCLUSION: Retrobulbar cellulitis/abscess is a serious and vision-threatening process, which can be effectively managed by broad-spectrum antibiotics such as gentamicin or amoxicillin/clavulanic acid, but not cefovecin. This study identified three organisms that have not been previously reported to be associated with orbital cellulitis (Corynebacterium sp., Bacillus sp. and Micrococcus sp.).
Assuntos
Celulite (Flegmão)/veterinária , Doenças do Cão/diagnóstico , Infecções Oculares Bacterianas/veterinária , Doenças Orbitárias/veterinária , Animais , Bacillus/isolamento & purificação , Cegueira/microbiologia , Cegueira/veterinária , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/epidemiologia , Celulite (Flegmão)/terapia , Corynebacterium/isolamento & purificação , Suscetibilidade a Doenças , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Doenças do Cão/terapia , Cães , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/epidemiologia , Infecções Oculares Bacterianas/terapia , Feminino , Masculino , Micrococcus/isolamento & purificação , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/epidemiologia , Doenças Orbitárias/terapia , Sudeste dos Estados Unidos/epidemiologia , Tomografia Computadorizada por Raios X/veterináriaRESUMO
We describe an elderly diabetic patient presenting with sudden onset right-sided proptosis and vision loss secondary to rhino-orbital mucormycosis and central retinal vascular occlusion. He underwent orbital exenteration that was complicated by intraoperative cerebrospinal fluid (CSF) leak from lateral orbital wall. The leak was surgically repaired and the patient recovered well. We postulate the cause of the CSF leak to be twofold: necrotic periorbital tissue due to mucormycosis rendering the thin bones susceptible to damage and second, intraoperative manipulation and dissection at the orbital apex with monopolar cautery and instruments. We describe measures taken to successfully repair the CSF leak and the possible precautions that can be taken to avoid it.
Assuntos
Vazamento de Líquido Cefalorraquidiano/etiologia , Complicações Intraoperatórias/etiologia , Mucormicose/terapia , Exenteração Orbitária/efeitos adversos , Doenças Orbitárias/terapia , Sinusite/terapia , Administração Intravenosa , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Blefaroptose/microbiologia , Cegueira/microbiologia , Vazamento de Líquido Cefalorraquidiano/diagnóstico , Vazamento de Líquido Cefalorraquidiano/cirurgia , Desbridamento , Diabetes Mellitus Tipo 2/imunologia , Endoscopia , Humanos , Hifas/isolamento & purificação , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/cirurgia , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/imunologia , Mucormicose/microbiologia , Órbita/diagnóstico por imagem , Órbita/microbiologia , Órbita/cirurgia , Doenças Orbitárias/complicações , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/microbiologia , Seios Paranasais/diagnóstico por imagem , Seios Paranasais/microbiologia , Seios Paranasais/cirurgia , Oclusão da Artéria Retiniana/diagnóstico , Oclusão da Artéria Retiniana/microbiologia , Sinusite/complicações , Sinusite/imunologia , Sinusite/microbiologia , Resultado do TratamentoRESUMO
Neisseria gonorrhoeae bacteria are acknowledged as an urgent threat to human health because this species has developed resistances to all of the antibiotics used clinically to treat its infections. N. gonorrhoeae causes the sexually transmitted disease gonorrhoea, but also causes blindness when the bacteria infect the eyes. Infants are particularly susceptible, acquiring the infection from their mothers at birth. We have shown that the monoglyceride monocaprin rapidly kills N. gonorrhoeae and other bacterial species and is non-irritating in ocular assays. Here we show that the physical and chemical properties of monocaprin make it ideal for use in a thickened eye drop formulation to combat eye infections. Monocaprin-containing formulations were assessed using analytical techniques and for antimicrobial activity in vitro and in ex vivo infections. Monocaprin-containing formulations retained activity after three years and are non-irritating, unlike preparations of povidone iodine in our assays. A recommended formulation for further development and investigation is 0.25% monocaprin in 1% HPMC with 1% polysorbate 20.
Assuntos
Antibacterianos/uso terapêutico , Cegueira/tratamento farmacológico , Composição de Medicamentos/métodos , Farmacorresistência Bacteriana/efeitos dos fármacos , Glicerídeos/uso terapêutico , Gonorreia/tratamento farmacológico , Neisseria gonorrhoeae/efeitos dos fármacos , Soluções Oftálmicas/uso terapêutico , Animais , Antibacterianos/farmacologia , Cegueira/microbiologia , Bovinos , Córnea/efeitos dos fármacos , Córnea/microbiologia , Glicerídeos/farmacologia , Gonorreia/microbiologia , Testes de Sensibilidade Microbiana , Soluções Oftálmicas/farmacologiaRESUMO
INTRODUCTION: Rhino-orbital-aspergillosis (ROA) is a rare but serious disease in immunocompetent patients. Diagnosis is often delayed due to the absence of specific clinical symptoms. We describe the case of a patient who presented initially with ROA which spread progressively to the right ethmoid-sphenoid sinuses and then to the brain. OBSERVATION: A 61-year-old patient with a history of well-controlled diabetes presented with a sudden severe decrease in right visual acuity. Cerebral MRI showed the presence of an infiltrate in the right orbital apex extending to the homolateral cavernous sinus without any cerebral involvement. A diagnosis of right orbital myositis was made and corticosteroid therapy was started. His symptoms worsened progressively leading to quasi-blindness. A new MRI showed the development of right sphenoid-ethmoid osteolytic lesions. A fungal aetiology was suspected and tests for fungal biomarkers found a ß-(1-3)-D-glucan level of 99pg/ml but negative galactomannan. An ethmoid biopsy was performed for histological and mycological investigations, including the detection of Aspergillus DNA by qPCR. qPCR was positive and culture resulted in the isolation of multi-sensitive Aspergillus fumigatus. Treatment was initiated with voriconazole. Due to persistence of blindness and the appearance of a lesion extending to the right frontal lobe, surgical excision was performed followed by antifungal treatment for a total duration of 1year. The patient is currently stable, but has persistence of blindness in the right eye. CONCLUSION: Invasive ROA is a rare but serious disease in immunocompetent patients which should be evoked in the differential diagnosis of a tumour or vasculitis. Early diagnosis is essential for optimal management.
Assuntos
Aspergilose/diagnóstico , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Infecções Oculares Fúngicas/microbiologia , Imunocompetência , Infecções Fúngicas Invasivas/diagnóstico , Rinite/microbiologia , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/microbiologia , Aspergillus fumigatus/isolamento & purificação , Cegueira/diagnóstico , Cegueira/microbiologia , Infecções Fúngicas do Sistema Nervoso Central/complicações , Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/microbiologia , Infecções Oculares Fúngicas/complicações , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/tratamento farmacológico , Humanos , Infecções Fúngicas Invasivas/tratamento farmacológico , Infecções Fúngicas Invasivas/microbiologia , Masculino , Pessoa de Meia-Idade , Neuroaspergilose/complicações , Neuroaspergilose/diagnóstico , Neuroaspergilose/tratamento farmacológico , Neuroaspergilose/microbiologia , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/tratamento farmacológico , Doenças Orbitárias/microbiologia , Rinite/complicações , Rinite/diagnóstico , Rinite/tratamento farmacológico , Voriconazol/uso terapêuticoRESUMO
The purpose of this article is to describe two paediatric neuro-ophthalmological clinical cases caused by a systemic infection due to Mycoplasma pneumoniae (M. pneumoniae). The cases are two girls aged 14 and 12 seen in the Emergency Department: The first one had internuclear ophthalmoplegia and second with loss of vision and headache. They had no other neurological foci. Magnetic resonance imaging showed hyperintense plaques in both, suggestive of a demyelinating disease. One month later, the neuro-ophthalmological symptoms resolved, with normal follow-up magnetic resonance imagings. The diagnosis was acute disseminated encephalitis secondary to M. pneumoniae. The diagnosis was made using PCR (gold standard) and/or IgM in serology. It is important to think about this possible aetiology in cases of suggestive demyelinating disease. There is controversy about the role of antibiotics and on whether corticosteroids are contemplated. In conclusion, M. pneumoniae must be a differential diagnosis in acute neuro-ophthalmological disorders in children.
Assuntos
Cegueira/microbiologia , Encefalite Infecciosa/microbiologia , Infecções por Mycoplasma , Mycoplasma pneumoniae , Transtornos da Motilidade Ocular/microbiologia , Doença Aguda , Adolescente , Criança , Feminino , HumanosAssuntos
Cegueira/microbiologia , Diabetes Mellitus Tipo 1/complicações , Infecções Oculares Fúngicas/microbiologia , Mucormicose/microbiologia , Doenças Orbitárias/microbiologia , Rinite/microbiologia , Acuidade Visual/fisiologia , Doença Aguda , Idoso , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Cegueira/tratamento farmacológico , Cegueira/fisiopatologia , Desbridamento , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/tratamento farmacológico , Dor Ocular/diagnóstico , Evolução Fatal , Humanos , Pressão Intraocular/fisiologia , Imageamento por Ressonância Magnética , Masculino , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/tratamento farmacológico , Rinite/diagnóstico , Rinite/tratamento farmacológico , Microscopia com Lâmpada de Fenda , Tomografia Computadorizada por Raios XAssuntos
Bem-Estar do Animal , Pesquisa Biomédica/ética , Cegueira/microbiologia , Anormalidades Congênitas/microbiologia , Toxoplasma , Toxoplasmose/prevenção & controle , Alternativas ao Uso de Animais , Animais , Gatos , Humanos , Laboratórios , Oocistos , Política , Estados Unidos , United States Department of AgricultureAssuntos
Encefalopatias/diagnóstico por imagem , Oftalmopatias/diagnóstico por imagem , Sinusite Maxilar/diagnóstico por imagem , Mucormicose/diagnóstico , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Cegueira/etiologia , Cegueira/microbiologia , Cegueira/terapia , Encefalopatias/microbiologia , Encefalopatias/terapia , Desbridamento , Exoftalmia/etiologia , Exoftalmia/microbiologia , Exoftalmia/terapia , Oftalmopatias/microbiologia , Oftalmopatias/terapia , Evolução Fatal , Feminino , Humanos , Imageamento por Ressonância Magnética , Sinusite Maxilar/microbiologia , Sinusite Maxilar/terapia , Pessoa de Meia-Idade , Mucormicose/diagnóstico por imagem , Mucormicose/microbiologia , Mucormicose/terapia , Neurite Óptica/diagnóstico por imagem , Neurite Óptica/microbiologia , Neurite Óptica/terapiaRESUMO
Trachoma is among the most common infectious causes of blindness. During January-May 2018, a total of 4 trachoma cases were diagnosed among Amerindians of the Yanomami ethnic group in 3 communities of southern Venezuela. This country has social and environmental conditions conducive to the endemicity of this neglected tropical disease.
Assuntos
Cegueira/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Tracoma/diagnóstico , Adulto , Cegueira/microbiologia , Feminino , Humanos , Indígenas Sul-Americanos , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas , Tracoma/microbiologia , Medicina Tropical , Venezuela , Adulto JovemAssuntos
Erradicação de Doenças/organização & administração , Educação em Saúde/organização & administração , Higiene , Tracoma/epidemiologia , Tracoma/prevenção & controle , Antibacterianos/uso terapêutico , Cegueira/microbiologia , Cegueira/prevenção & controle , Comportamento Cooperativo , Progressão da Doença , Meio Ambiente , Humanos , Internacionalidade , Procedimentos Cirúrgicos Oftalmológicos/métodos , Tracoma/terapia , Organização Mundial da SaúdeRESUMO
PURPOSE: To report a case of complete ophthalmoplegia and blindness in sino-orbital mucormycosis. CASE REPORT: A 68-year-old woman with history of diabetes and breast cancer presented with sudden onset of fever, orbital pain and blindness in the right eye. The patient was found to have no light perception, complete ophthalmoplegia, chemosis, corneal ulcer and optic nerve atrophy. In rhinologic examination, necrosis was noticed. Brain and orbit magnetic resonance imaging showed diffuse sinusitis with orbital involvement. The result of the clinical examination was reported as sino-orbitalmucormycosis. The diagnosis was confirmed by pathological specimens. The patient underwent extensive surgical debridement and systemic antifungal treatment. Despite treatment, visual acuity did not recover. CONCLUSION: The sino-orbital form of mucormycosis is a rare and insidious fungal infection. Ocular findings may range from orbital pain to ophtalmoplegia and blindness such as in our case. Black scar tissues seen on the nasal mucosa are pathognomonic. Delay in treatment due to late presentation and complications were major determinants in ocular prognosis and survival outcome.
Assuntos
Infecções Oculares Fúngicas/complicações , Mucormicose/complicações , Oftalmoplegia/complicações , Doenças Orbitárias/complicações , Doenças dos Seios Paranasais/complicações , Idoso , Cegueira/complicações , Cegueira/diagnóstico , Cegueira/microbiologia , Infecções Oculares Fúngicas/diagnóstico , Feminino , Humanos , Mucormicose/diagnóstico , Oftalmoplegia/diagnóstico , Oftalmoplegia/microbiologia , Doenças Orbitárias/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Mucormycosis is a rare but serious type of fungal infection, which can progress rapidly especially in immunsupressed patients.We report about a 47 year old female patient with ptosis on the left eye. The ophthalmological report offered no further pathologic findings. Diabetes mellitus was known and the blood sugar value was very high.A computed tomography of the paranasal sinuses showed a shadow in the ethmoid bone and in an additonally performed MRI-scan, an increase of orbital fat and an extension of the ocular muscle were visible.As the patient lost her ability o look above, an operation of the paranasal sinus was done.The microbial results revealed a Mucormycosis (Lichtheimia). As the patient went blind in the further course, indication for orbital exenteration on the left side and revision of the paranasal sinus was given. High doses of Liposomal Ampthotericin B and Posaconazol were given and blood sugar was monitored very strictly. MRI-scans revealed a further progression of the infection and required additional surgeries and a dura resection accompanied by complications like recurrent septical episodes, renal insufficiency, a bifrontal epidural hematoma and multiple cerebral microinfarcts that impeded the recovery of our patient in the further course. After 8 months she was able to leave the hospital, an epithesis was adjusted and she is without a relapse for 24 month since the diagnosis.
Assuntos
Mucormicose , Doenças Orbitárias , Doenças dos Seios Paranasais , Antifúngicos/uso terapêutico , Cegueira/microbiologia , Feminino , Humanos , Pessoa de Meia-Idade , Seios Paranasais/diagnóstico por imagemRESUMO
Tuberculosis (TB) remains a worldwide burden, with a large majority of new active TB cases occurring in underdeveloped and developing countries. Tuberculous meningitis (TBM) is one of the common infections of central nervous system. Other manifestations include intracranial tuberculoma, tubercular brain abscess, spinal tuberculoma, and granulomatous arachnoiditis. Visual impairment in TBM may be due to optic neuritis, optochiasmatic arachnoiditis (OCA), tuberculoma in the chiasmatic region or in the optic pathways, chorioretinitis, secondary to hydrocephalus and increased intracranial pressure, and finally due to ethambutol toxicity. We report a case of young girl with concurrent spinal cord intramedullary tuberculoma and multiple intracranial tuberculomas with TBM and bilateral visual impairment due to tuberculous optic neuritis.
Assuntos
Neurite Óptica/microbiologia , Doenças da Medula Espinal/complicações , Tuberculoma Intracraniano/complicações , Tuberculose Meníngea/complicações , Cegueira/microbiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Doenças da Medula Espinal/diagnóstico por imagem , Tuberculoma Intracraniano/diagnóstico por imagem , Tuberculose Meníngea/diagnóstico por imagem , Adulto JovemAssuntos
Cegueira/diagnóstico , Seio Etmoidal/microbiologia , Fusariose/complicações , Fusariose/diagnóstico , Nervo Óptico/microbiologia , Idoso , Cegueira/tratamento farmacológico , Cegueira/etiologia , Cegueira/microbiologia , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Diagnóstico Diferencial , Seio Etmoidal/patologia , Evolução Fatal , Feminino , Fusariose/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/tratamento farmacológico , Síndromes Mielodisplásicas/imunologia , Síndromes Mielodisplásicas/microbiologia , Nervo Óptico/patologia , Voriconazol/uso terapêuticoRESUMO
BACKGROUND: Ocular Chlamydia trachomatis (Ct) infection causes trachoma, the leading infectious cause of blindness. A Ct D/UW3 proteome microarray and sera from Gambian adults with trachomatous trichiasis (TT) or healthy matched controls previously identified several novel antigens, which suggested differential recognition in adults with TT. METHODS: We re-analysed this serological microarray data using more robust microarray analysis techniques accounting for typical problems associated with highly dimensional data. We examined the Ct-specific antibody profile concerning the overall diversity of responses, antigen expression stage and cellular localisation of antigens. We tested differentially recognised antigens by further serological testing of the screened sera and used larger independent sample sets for validation. RESULTS: Antibody responses identified High-Performance on antigens expressed early and late in the Ct developmental cycle and those secreted or localised to the outer membrane. Eight antigens were preferentially recognised by scarred individuals and one antigen by healthy individuals. Three of these antigens, two associated with scarring (CT667 and CT706) and one healthy-associated (CT442), were not associated with the presence or absence of scarring following specific serological testing of the arrayed sera and sera from larger, independent case-control cohorts. CONCLUSIONS: This study identified focussed Ct-specific antibody profiles targeting proteins expressed during entry and exit from cells and localised to interact with the host. A small panel of antibody responses could discriminate between adults with and without TT in a trachoma-endemic community. Heterogenous responses in the independent validation of these antibody targets highlighted the need for large sample sizes, clearly defined clinical phenotypes and follow-up work.
Assuntos
Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Chlamydia trachomatis/imunologia , Tracoma/imunologia , Triquíase/imunologia , Adolescente , Adulto , Idoso , Cegueira/microbiologia , Criança , Feminino , Gâmbia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Proteômica/métodos , Tracoma/epidemiologia , Tracoma/microbiologia , Triquíase/epidemiologia , Triquíase/microbiologia , Adulto JovemRESUMO
OBJECTIVE: To present the change in the prevalence of blindness caused by trachoma between 1987 and 2006 by secondary data analysis based on two China National Sample Surveys on Disability (CNSSD). METHODS: Secondary data analysis was performed on two China National Sample Surveys on Disability (CNSSD), which were national representative household surveys conducted in 1987 and 2006. The prevalence of blindness caused by trachoma was estimated by 10-year age group. In addition, the proportion of various causes of blindness was evaluated. The geographical distribution of blindness caused by trachoma both in 1987 and 2006 was analyzed in order to visualize the hot spots of blinding trachoma in China. RESULTS: The prevalence of blindness caused by trachoma in China decreased from 51.5/100,000 in 1987 to 17.6/100,000 in 2006. In addition, the proportion of blindness attributed to trachoma also decreased from 10.1% (1987) to 0.9% (2006). Moreover, the prevalence of blindness caused by trachoma was over 200/100,000 in 2.2% of sampled counties in 2006 as compared to 8.6% in 1987. The hot spots of blinding trachoma were shown to be limited to underdeveloped mountain areas in Hubei and Guizhou provinces. CONCLUSION: Although blinding trachoma is no longer the leading cause of blindness in China since the 2000's, the prevalence of trachoma should still be monitored in some underdeveloped mountain areas. Therefore, health organization must continue to fight against blinding trachoma in underdeveloped areas.
Assuntos
Cegueira/epidemiologia , Cegueira/prevenção & controle , Erradicação de Doenças , Tracoma/epidemiologia , Tracoma/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Cegueira/diagnóstico , Cegueira/microbiologia , Criança , China/epidemiologia , Humanos , Recém-Nascido , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Tracoma/complicações , Tracoma/diagnóstico , Adulto JovemRESUMO
A man aged 77â years with postrenal transplant lymphoproliferative disease was admitted with high fever, elevated inflammatory markers and a heart murmur. Blood cultures grew Enterococcus faecalis and he was found to have mitral valve endocarditis on echocardiogram and subsequently started on appropriate antibiotics. 5 days into treatment, he developed ocular symptoms and 3â days later, he had irreversible monocular visual loss. He was seen by the ophthalmology team who diagnosed endogenous endopthalmitis secondary to bacteraemic spread from his endocarditis. Despite treatment with intravitreal antibiotics and prolonged systemic antibiotics, his sight did not recover. Although septic emboli are common in endocarditis, endogenous endophthalmitis is rarely reported and frequently results in visual loss. Early treatment confers an improved prognosis.
Assuntos
Cegueira/microbiologia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/microbiologia , Idoso , Antibacterianos/uso terapêutico , Cegueira/diagnóstico , Cegueira/tratamento farmacológico , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/tratamento farmacológico , Enterococcus faecalis/isolamento & purificação , Evolução Fatal , Humanos , Transplante de Rim , Transtornos Linfoproliferativos/imunologia , MasculinoRESUMO
BACKGROUND: Acute vision loss in the post-partum period can occur due to many reasons. Eclampsia, posterior reversible encephalopathy syndrome (PRES), pituitary apoplexy, and central serous retinopathy are some of the important causes. Cryptococcal meningitis as a cause of acute vision loss in the post-partum period has not been mentioned in literature. CASE PRESENTATION: A 25-year-old female presented to us with acute bilateral complete vision loss in the post-partum period. Her serum was tested positive for HIV antibodies. Cerebrospinal fluid (CSF) examination revealed cryptococcal meningitis. She was started on amphotericin B, antiretroviral drugs, and steroids. Though symptoms of meningitis resolved after treatment no significant improvement in vision was observed at 3 months. CONCLUSIONS: Cryptococcal meningitis may be considered as one of the causes of acute vision loss in pregnant/post-partum females with human immunodeficiency virus (HIV) positivity.