RESUMO
Utilizing transmission electron microscopy, the authors describe results obtained from cellulose acetate impressions of the bulbar conjunctiva in acquired immunodeficiency syndrome patients with cytomegalovirus (CMV) retinitis. Particles consistent with a retrovirus were isolated, but no CMV particles were demonstrated.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Túnica Conjuntiva/microbiologia , Infecções por Citomegalovirus/microbiologia , Infecções Oculares Virais/microbiologia , HIV-1/ultraestrutura , Retinite/microbiologia , Túnica Conjuntiva/ultraestrutura , Epitélio/microbiologia , Epitélio/ultraestrutura , Infecções por HIV/complicações , Humanos , MasculinoRESUMO
A 38-year-old bisexual man with acquired immunodeficiency syndrome (AIDS) who was being treated with oral acyclovir for herpetic stomatitis had a history of blurred vision OS that was diagnosed as cytomegalovirus retinitis. The patient refused ganciclovir administration. Two additional lesions developed OS in the succeeding four months. All clinical evidence of active retinitis cleared after zidovudine was administered, and the patient has remained free of any clinically active retinal lesions for 28 months while continuing to receive acyclovir and zidovudine. Although ganciclovir and foscarnet are the drugs of choice to treat cytomegalovirus retinitis, this observation may be fortuitous for patients whose other AIDS manifestations suggest using zidovudine rather than ganciclovir or for patients whose cytomegalovirus retinitis appears to be resistant to agents currently used to treat this infection.
Assuntos
Infecções por Citomegalovirus/tratamento farmacológico , Infecções Oculares Virais/tratamento farmacológico , Retinite/tratamento farmacológico , Zidovudina/uso terapêutico , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Aciclovir/uso terapêutico , Adulto , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Soropositividade para HIV/complicações , Soropositividade para HIV/tratamento farmacológico , Humanos , Masculino , Retinite/microbiologia , Acuidade VisualRESUMO
A 76-year-old woman had a slowly enlarging lesion of the right lower eyelid. After obtaining incisional biopsy results consistent with adenocarcinoma, we removed the tumor and made a final diagnosis of primary mucinous adenocarcinoma of the sweat gland. The defect was repaired using ipsilateral upper lid transpositional tarso-conjunctival and skin-muscle flaps. No evidence of recurrence or metastasis was noted 42 months postoperatively. Consideration of such tumors is clinically important, since they have full metastatic potential. We therefore suggest consideration of sweat gland primary mucinous adenocarcinoma in the differential diagnosis of red or violaceous eyelid masses.