Persistence of Ebola Virus in Ocular Fluid during Convalescence.

Among the survivors of Ebola virus disease (EVD), complications that include uveitis can develop during convalescence, although the incidence and pathogenesis of EVD-associated uveitis are unknown. We describe a patient who recovered from EVD and was subsequently found to have severe unilateral uveitis during convalescence. Viable Zaire ebolavirus (EBOV) was detected in aqueous humor 14 weeks after the onset of EVD and 9 weeks after the clearance of viremia.

Mesenteric Castleman Disease Mimicking Neuroendocrine Tumor.

Castleman disease (CD) is a benign lymphoproliferative disorder of unknown etiology, which can involve any part of the body. CD can involve a single lymph node (unicentric) or multiple lymph nodes (multicentric) of which unicentric CD is the most common type. The unicentric CD is usually localized, asymptomatic, and often appears as an incidental mass on radiographs, whereas multicentric CD is characterized by systemic involvement. Mesenteric involvement of CD is very rare. In this article, we present a case of the unicentric CD of small bowel mesentery, which mimicked a neuroendocrine tumor preoperatively.

Recent advancements in multifaceted roles of flavonoids in plant-rhizomicrobiome interactions.

The rhizosphere consists of a plethora of microbes, interacting with each other as well as with the plants present in proximity. The root exudates consist of a variety of secondary metabolites such as strigolactones and other phenolic compounds such as coumarin that helps in facilitating communication and forming associations with beneficial microbes in the rhizosphere. Among different secondary metabolites flavonoids (natural polyphenolic compounds) continuously increasing attention in scientific fields for showing several slews of biological activities. Flavonoids possess a benzo-γ-pyrone skeleton and several classes of flavonoids have been reported on the basis of their basic structure such as flavanones, flavonols, anthocyanins, etc. The mutualistic association between plant growth-promoting rhizobacteria (PGPR) and plants have been reported to help the host plants in surviving various biotic and abiotic stresses such as low nitrogen and phosphorus, drought and salinity stress, pathogen attack, and herbivory. This review sheds light upon one such component of root exudate known as flavonoids, which is well known for nodulation in legume plants. Apart from the well-known role in inducing nodulation in legumes, this group of compounds has anti-microbial and antifungal properties helping in establishing defensive mechanisms and playing a major role in forming mycorrhizal associations for the enhanced acquisition of nutrients such as iron and phosphorus. Further, this review highlights the role of flavonoids in plants for recruiting non-mutualistic microbes under stress and other important aspects regarding recent findings on the functions of this secondary metabolite in guiding the plant-microbe interaction and how organic matter affects its functionality in soil.

Liver Parenchymal Transection Through Radiofrequency Ablation Using a Radial Probe: Technical Report of a New Modality.

Various techniques have been reported to reduce blood loss during a parenchymal transection, and the radiofrequency ablation (RFA) technique is one of them. Owing to the charring of the adjacent liver tissue and the inability to use the conventional RFA techniques near major vessels, this study used a radial fiber of RFA. This technical report thus describes a technique to perform parenchymal transection using a radial fiber as well as its advantages and disadvantages. A radial fiber dissipates the energy radially and it has the added advantage of placing along the same and perpendicular axis of the liver parenchyma; it has been used in three patients in this study. The total intraoperative blood loss was 30-50 ml during parenchymal transection, and the intraoperative duration was 120-170 min. Bile leak was noted in one patient, which was then managed using the conventional treatment. Through the present technique, the fiber can be used in the vicinity of major blood vessels and necrosis and charring can be prevented. Although radial fiber has some advantages, it remains in the preliminary stage and requires further validation.

Recurrent CMV retinitis in a non-HIV patient with drug-resistant CMV.

BACKGROUND: We report a case of recurrent cytomegalovirus (CMV) retinitis in an HIV-negative patient with CD4+ T lymphocytopenia. METHODS: Case report. RESULTS: A 41-year-old HIV-negative woman with a history of systemic lupus erythematosus, idiopathic thrombocytopenic purpura requiring splenectomy, and diabetes presented with primary CMV infection, high-grade viremia, CMV pneumonia followed by CMV retinitis (CMVR) and a CD4+ T lymphocyte (CD4) count of 12 cells/mm(3) after therapy with rituximab, prednisone, and methotrexate. Persistent CMV viremia led to genotypic analysis of the circulating virus, which revealed UL97 and UL54 mutations known to be associated with resistance to ganciclovir (GCV) and cidofovir. CMV clearance from the bloodstream followed systemic antiviral therapy and recovery of CD4 cell count. However, CMVR recurred multiple times despite GCV implants, systemic valganciclovir, intravitreal GCV injections, and persistent CD4 counts greater than 100 cells/mm(3). Recurrent episodes of CMVR responded to multiple high dose intravitreal GCV injections (5000-6000 micrograms) and recovery of CD4 cell counts to greater than 200 cells/mm(3). CONCLUSION: This case demonstrates that recurrent CMVR occurs in HIV-negative patients at CD4 cell counts thought to be protective in HIV patients, and suggests that an ineffective local immune response to retinal infection combined with CMV drug resistance may have been important factors leading to recurrent disease in this patient. Treatment producing high local concentrations of GCV may be effective therapy for CMV retinitis due to GCV-resistant virus.

Bilateral acute retinal necrosis in a patient with multiple sclerosis on natalizumab.

PURPOSE: The purpose of this study is to report a case of bilateral acute retinal necrosis in a patient with multiple sclerosis treated with natalizumab. METHODS: This study is a case report and literature review. RESULTS: A 34-year-old Caucasian female with multiple sclerosis presented with 1 week of blurry vision in both eyes during treatment with natalizumab. Clinical examination revealed bilateral acute retinal necrosis. The patient was treated with systemic intravenous acyclovir and intravitreal injections foscarnet and ganciclovir. Natalizumab therapy was also discontinued. CONCLUSIONS: Natalizumab is a potent immunosuppressive agent used in relapsing remitting multiple sclerosis and Crohn's disease. The use of this medication is commonly associated with opportunistic infections in the CNS. In rare cases, ocular opportunistic infections may occur and can lead to significant visual impairment and blindness. Neurologists and ophthalmologists should be aware of this potential complication.

Microstructural retinal findings by spectral-domain optical coherence tomography after vitrectomy repair of rhegmatogenous retinal detachments.

BACKGROUND AND OBJECTIVE: To evaluate macular microstructural changes after macula-involving rhegmatogenous retinal detachment repair and correlate with visual recovery. PATIENTS AND METHODS: A prospective, observational study was performed of select patients presenting with macula-involving rhegmatogenous retinal detachments (RRD). Spectral-domain optical coherence tomography (SD-OCT) imaging was performed at postoperative visits over the course of the first year after operative repair of the RRD. RESULTS: The maculas of seven patients were evaluated. Postoperative best corrected visual acuity (BCVA) at the final follow-up ranged from 20/20 to 20/70 for all patients. Eyes with final BCVA greater than 20/40 had intact external limiting membrane and outer photoreceptor structures, while those with BCVA of less than 20/70 had poorer definition to those structures. Serial images showed resolution of irregularities in both the external limiting membrane and outer photoreceptor structures. CONCLUSION: Macular structure and function can progressively improve in the first year after successful RRD repair, including in the external limiting membrane, damage to which has previously been thought to be irreversible. SD-OCT serves as a useful tool to monitor postoperative retinal recovery.