Granulomatous meningoencephalitis and blindness associated with Mycobacterium tuberculosis complex infection in a senile female chimpanzee (Pan troglodytes).

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.

Canine Retrobulbar Cellulitis and Abscessation in the Southeastern United States: A review of case management, diagnostic imaging, bacterial isolates, and susceptibility patterns.

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.).

Trachoma in 3 Amerindian Communities, Venezuelan Amazon, 2018.

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.

[Rhinocerebral Mucormycosis]. / Rhinocerebrale Mucormykose.

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.

Ophtalmoplegia complicating sino-orbital mucormycosis.

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.

Acute vision loss in post-partum period as presenting symptom of HIV-associated cryptococcal meningitis-an unusual case report.

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.

Fungal endophthalmitis associated with compounded products.

Fungal endophthalmitis is a rare but serious infection. In March 2012, several cases of probable and laboratory-confirmed fungal endophthalmitis occurring after invasive ocular procedures were reported nationwide. We identified 47 cases in 9 states: 21 patients had been exposed to the intraocular dye Brilliant Blue G (BBG) during retinal surgery, and the other 26 had received an intravitreal injection containing triamcinolone acetonide. Both drugs were produced by Franck's Compounding Lab (Ocala, FL, USA). Fusarium incarnatum-equiseti species complex mold was identified in specimens from BBG-exposed case-patients and an unopened BBG vial. Bipolaris hawaiiensis mold was identified in specimens from triamcinolone-exposed case-patients. Exposure to either product was the only factor associated with case status. Of 40 case-patients for whom data were available, 39 (98%) lost vision. These concurrent outbreaks, associated with 1 compounding pharmacy, resulted in a product recall. Ensuring safety and integrity of compounded medications is critical for preventing further outbreaks associated with compounded products.

Fungal ball within Onodi cell mucocele causing visual loss.

The Onodi cell is a pneumatized posterior ethmoid cell located laterally and superiorly to the sphenoid sinus and closely related to the optic nerve. A mucocele is a benign, expansile, cystlike lesion of the paranasal sinuses that is filled with mucoid secretion. Therefore, optic neuropathy caused by an infected mucocele in an Onodi cell is uncommon. Furthermore, fungal infection superimposed on an Onodi cell mucocele is extremely rare and has not been reported previously. Here, we describe the first case of fungal ball within Onodi cell mucocele causing visual loss, which was completely removed via transnasal endoscopic approach.

Ocular syphilis in a patient with HIV.

Patients who are HIV-positive and have ocular complaints may have ocular syphilis as coinfection with HIV and syphilis is common, and genital ulcerative diseases may facilitate HIV infection. Early treatment with IV penicillin can reduce the risk of vision loss.

Sudden loss of vision in an Acute Medical Unit.

We present a case report of young man with Type 1 diabetes who developed acute visual loss after initially presenting with diabetic ketoacidosis. The diagnosis of invasive paranasal sinusoidal aspergillosis was made following CT and biopsy. Although uncommon, visual loss is a recognised complication of disseminated aspergillosis and is more likely in immune-compromised patients and those with diabetes. Early investigation with appropriate sinus imaging and involvement of the Ear Nose and Throat team in recommended when patients with diabetes develop acute visual loss in the context of a non-specific infective illness.

"The blinding disease". The history of trachoma in Italians between the 19th and 20th centuries: colonial or national blindness?

Trachoma is one of the oldest known causes of blindness in humans and it is caused by the intracellular Gram-negative bacterium Chlamydia trachomatis serovars A, B, Ba and C. Its transmission has historically been related to poorness, overcrowded housing and scarce hygiene. We have traced the history of trachoma in Italy in the 19th and 20th centuries, among people living in Italy, those who immigrated to America and the population in the colonies, with a focus on Libya (1912-1943). Trachoma knowledge and perception in Italy and in its colonies was ambiguous during the 19th and 20th centuries. Trachoma was responsible for a great morbidity on both sides of the Mediterranean, in Italy as well as in Libya. Trachoma is still one of the leading infectious causes of preventable blindness worldwide and it was widespread in Italy and the Italian colonies in the first half of the last century.

Meningitis caused by an unusual genotype (ST3) of Streptococcus suis.

We describe a case of meningitis due to Streptococcus suis with the unusual ST3 genotype. The bacterial pathogen was isolated from blood samples. S. suis genotype ST3 was initially isolated from carrier pigs, but it has not been previously associated with invasive human infections. The patient developed serious endogenous bilateral endophthalmitis which resulted in severe visual deficiency.

Cavernous sinus thrombosis as a result of a fungal infection: a case report.

Cavernous sinus thrombosis (CST) is a rare disease with the potential for significant morbidity and even death. Rapid diagnosis and aggressive medical and surgical management are imperative for patients with CST. The cause may be aseptic or infectious. When the cause is infectious in nature, it is most commonly from a bacterial origin. However, we present the case of a 57-year-old man with a fungally related CST that ultimately led to his death.

Therapeutic contact lens-related infection by a novel pathogenic fungus Coniochaeta hoffmannii-a case report.

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.

Neuro-ophthalmic manifestations of fungal disease associated with posthurricane environment.

BACKGROUND: Allergic fungal sinusitis (AFS) is thought to represent an immunologic response to exposure to dematiaceous fungi. These fungi are known to cause disease more frequently in hot and humid climates and seasons. METHODS: Three patients presented with unusual manifestations of fungal disease after exposure to environments recently affected by hurricanes. RESULTS: Two patients had AFS, 1 with gradual painless visual loss from an AFS mass extending into the suprasellar region and 1 with orbital apex syndrome. Another patient had invasive fungal disease and developed orbital apex syndrome. CONCLUSIONS: These cases underscore the importance of clinical recognition of fungal disease in patients with sinus, orbital, or skull base involvement as well as its potential for causing permanent visual loss. This report suggests a potential association between fungal disease and tropical storm exposure.

Ocular complications of cryptococcal meningitis in patients with HIV: report of two cases and review of the literature.

AIDS-related cryptococcal meningitis can result in significant vision loss, but the risk factors, prognostic features, and optimal management of patients with ocular complications is unknown. We present 2 cases of blindness associated with cryptococcal meningitis and review the literature for associated cases. Twenty-six additional cases of vision deterioration or loss as a result of HIV-associated cryptococcal meningitis were reviewed. Irreversible and complete loss of vision occurred in 14 patients (50%). Permanent vision loss was more likely to occur in patients with ocular symptoms and neurologic signs at presentation. Nearly all patients with permanent visual loss experienced blindness within the first week after hospital admission. Visual complications are not uncommon in cryptococcal meningitis, and once vision loss occurs, it is often irreversible regardless of control of infection or intracranial pressure. Visual complaints in cryptococcal meningitis should be considered a potentially poor prognostic sign.

Rab6 and Rab11 regulate Chlamydia trachomatis development and golgin-84-dependent Golgi fragmentation.

Many intracellular pathogens that replicate in special membrane bound compartments exploit cellular trafficking pathways by targeting small GTPases, including Rab proteins. Members of the Chlamydiaceae recruit a subset of Rab proteins to their inclusions, but the significance of these interactions is uncertain. Using RNA interference, we identified Rab6 and Rab11 as important regulators of Chlamydia infections. Depletion of either Rab6 or Rab11, but not the other Rab proteins tested, decreased the formation of infectious particles. We further examined the interplay between these Rab proteins and the Golgi matrix components golgin-84 and p115 with regard to Chlamydia-induced Golgi fragmentation. Silencing of the Rab proteins blocked Chlamydia-induced and golgin-84 knockdown-stimulated Golgi disruption, whereas Golgi fragmentation was unaffected in p115 depleted cells. Interestingly, p115-induced Golgi fragmentation could rescue Chlamydia propagation in Rab6 and Rab11 knockdown cells. Furthermore, transport of nutrients to Chlamydia, as monitored by BODIPY-Ceramide, was inhibited by Rab6 and Rab11 knockdown. Taken together, our results demonstrate that Rab6 and Rab11 are key regulators of Golgi stability and further support the notion that Chlamydia subverts Golgi structure to enhance its intracellular development.