scholarly journals Corneal Phaeohyphomycosis Caused by Bipolaris hawaiiensis

2016 ◽  
Vol 7 (2) ◽  
pp. 364-371 ◽  
Author(s):  
Winai Chaidaroon ◽  
Sumet Supalaset ◽  
Napaporn Tananuvat ◽  
Nongnuch Vanittanakom
Keyword(s):  
Fungal Infection ◽  
Penetrating Keratoplasty ◽  
Corneal Ulcer ◽  
Nucleotide Sequence Analysis ◽  
Laboratory Findings ◽  
History Of ◽  
Oral Itraconazole ◽  
Eye Examination ◽  
Diagnostic Clue ◽  
Therapeutic Penetrating Keratoplasty

Purpose: To report a rare case of keratitis infected by Bipolaris hawaiiensis. Methods: A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. Results: A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identified B. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty. Conclusions: B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection.

scholarly journals Pigmented Corneal Ulcer

2019 ◽  
Author(s):  
Sonam Yangzes ◽  
Parul Chawla Gupta ◽  
Vivek Jha ◽  
Jagat Ram
Keyword(s):  
Amphotericin B ◽  
Corneal Ulcer ◽  
Clinical Feature ◽  
Slit Lamp ◽  
Dematiaceous Fungi ◽  
Laboratory Findings ◽  
History Of ◽  
Oral Itraconazole ◽  
Brownish Black ◽  
Vegetative Matter

Purpose: To report the clinical characteristics, laboratory findings, and treatment of a rare case of keratitis caused by pigmented fungi Bipolaris hawaiiensis. Case Report: A 55-year-old man presented with a history of trauma with vegetative matter in his left eye. Slit lamp biomicroscopic examination revealed the presence of a brownish-black pigmented plaque with surrounding infiltrates. Corneal scrapings revealed multiple septate hyphae. Culture revealed growth of the Bipolaris species. The patient was treated with topical natamycin 5%, topical voriconazole 1%, and oral itraconazole followed by intracameral amphotericin B (5 μg/mL). The patient responded well to the treatment. Conclusion: Brown pigmented infiltrates are an important clinical feature of dematiaceous fungi. B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. Our patient responded well to intracameral amphotericin B, which obviated the need for penetrating keratoplasty.

scholarly journals Pulmonary fungal ball due to Trichophyton successfully managed with oral itraconazole: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110662
Author(s):  
Hsu-Lin Lee ◽  
Li-Mien Chen ◽  
Chen-Chu Chang ◽  
Guan-Liang Chen
Keyword(s):  
Fungal Infection ◽  
Left Lung ◽  
Lavage Fluid ◽  
Lung Field ◽  
Fungal Culture ◽  
Lung Lobe ◽  
Recommended Treatment ◽  
History Of ◽  
Oral Itraconazole

Pulmonary fungal balls are caused by long-term fungal infection of the lung. They are sometimes a complication of previous cavitary pulmonary tuberculosis. Pulmonary fungal balls caused by Trichophyton are extremely rare. A 65-year-old man who worked in a leather recycling factory was admitted because of a productive cough and shortness of breath. He had a history of tuberculosis with lung destruction. A chest radiograph showed an opacity surrounding an air lucency over the left lung field, and chest computed tomography showed a mass within a cavity, producing a ball-in-hole appearance, over the left upper lung lobe. Bronchoalveolar lavage was performed, and fungal culture of the lavage fluid yielded Trichophyton. After 6 months of treatment with oral itraconazole, the patient’s general condition improved. This case emphasizes the importance of awareness of fungal infection within cavitary lesions of the lung and shows that Trichophyton may be the etiologic organism in such cases. Itraconazole is a recommended treatment of pulmonary fungal balls.

Therapeutic Penetrating Keratoplasty in Nonhealing Corneal Ulcer

1995 ◽  
Vol 26 (4) ◽  
pp. 325-329
Author(s):  
Anita Panda ◽  
Sudarshan Khokhar ◽  
Venkateshwar Rao ◽  
Gopal Krushna Das ◽  
Namrata Sharma
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Ulcer ◽  
Therapeutic Penetrating Keratoplasty

scholarly journals Assessment of Clinical Outcome Following Therapeutic Penetrating Keratoplasty in Non-Healing Infective and Perforated Corneal Ulcer

2021 ◽  
Vol 10 (43) ◽  
pp. 3670-3675
Author(s):  
Suria Rashmi C. ◽  
Gajaraj Tulsidas Naik ◽  
Satish K. ◽  
Meghana Neeralgi ◽  
Mohamed Abdul Kayoom ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Penetrating Keratoplasty ◽  
Structural Integrity ◽  
Corneal Ulcer ◽  
Visual Outcome ◽  
Visual Disability ◽  
Tissue Quality ◽  
Corneal Ulcers ◽  
Corneal Blindness ◽  
Therapeutic Penetrating Keratoplasty

BACKGROUND Corneal blindness has been a significant visual disability in developing countries like India. Corneal ulcer contributes mainly as the leading cause for monocular blindness. Considering the common condition, the studies and literature have been surprisingly less when it comes to corneal ulcer and their management. But with the advent of therapeutic penetrating keratoplasty (TPK), the scenario and prevalence of corneal blindness can be reduced. Hence this study was done to know the importance of therapeutic penetrating keratoplasty in case of non-healing infective and perforated corneal ulcers. The objectives were to assess the clinical outcome in a non-healing and perforated corneal ulcer, reduction in symptoms and signs of infection, anatomical or structural integrity of the globe and also evaluate the visual outcome following therapeutic penetrating keratoplasty. METHODS Data were obtained from 30 patients operated at our institute for therapeutic penetrating keratoplasty. Patients with less than one year of follow up, paediatric cases, PL negative cases were excluded. The outcome was assessed based on maintenance of structural integrity, reduction in infective load, improvement in visual acuity and graft survival and its correlation with corneal vascularisation, previously failed grafts, donor tissue quality, graft size and type of surgery. RESULTS Structural integrity was maintained in 93.3 % of the cases, reduction of infective load in 90 % of cases and optically clear grafts in 46.7 % of cases and vision was better than 6/60 in 30 % of cases. CONCLUSIONS The study proved that in the case of non-healing and perforated corneal ulcers, therapeutic penetrating keratoplasty had a good prognosis in reducing infective load, maintaining structural integrity without which eye could have been lost. KEYWORDS Therapeutic Penetrating keratoplasty, Perforated corneal ulcer, non-healing corneal ulcer, corneal blindness, TPK

scholarly journals Pythium keratitis: clinical course of an emerging scourge

2020 ◽  
Vol 17 (3) ◽  
pp. 318-323
Author(s):  
Radhika Natarajan ◽  
Ankit Anil Harwani ◽  
Ramya Ravindran
Keyword(s):  
Polymerase Chain Reaction ◽  
Confocal Microscopy ◽  
Penetrating Keratoplasty ◽  
Clinical Presentation ◽  
Corneal Ulcer ◽  
Clinical Course ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Therapeutic Penetrating Keratoplasty

We hereby report two cases of the emerging and devastating Pythium keratitis for their different presentations, prolonged clinical course, and suspicion of recurrence after therapeutic penetrating keratoplasty (TPK). The history, clinical presentation, investigations including smears, cultures, polymerase chain reaction (PCR) and confocal microscopy, the tumultuous course of the infection, and outcome of TPK have been discussed for two cases having this unusual and severe emerging infection. These two cases demonstrate that Pythium keratitis can present as a central reticular or peripheral guttering corneal ulcer with dense infiltration. PCR is a valuable tool for diagnosis. Pythium keratitis has a severe and prolonged clinical course. Response to antibiotics is modest and needs to be closely monitored. It can present with inflammation after TPK that mimics the dreaded recurrence of the infection. Pythium keratitis presents variably and can be suspected from typical clinical and microbiological findings. It needs protracted treatment with close follow-up. Although the infection is known torecur in the therapeutic graft, not all recurrences are what they seem.

scholarly journals Acanthamoeba Keratitis – A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 133-136
Author(s):  
Leesha Shrestha Joshi ◽  
Reeta Gurung
Keyword(s):  
Poor Prognosis ◽  
Severe Pain ◽  
Corneal Ulcer ◽  
Acanthamoeba Keratitis ◽  
Eye Drops ◽  
E Coli ◽  
Serious Infection ◽  
History Of ◽  
Vegetative Matter ◽  
Therapeutic Penetrating Keratoplasty

Introduction: Acanthamoeba keratitis is a serious infection of the cornea which causes severe inflammation of the eye and loss of vision. Case description: A 45 years female came with a history of trauma of right eye with vegetative matter with severe pain and redness. Patient was treated with antibacterial, antifungal eye drops but the condition deteriorated. Diagnosis was based on presence of motile trophozoites and cyst in the culture of non nutrient agar with a lawn of E coli of the corneal ulcer scraping. Therapeutic penetrating keratoplasty was performed as the patient’s condition deteriorated. Conclusion: Acanthamoeba keratitis is a rare parasitic vision threatening infection with poor prognosis in comparison to other infectious keratitis. Therefore prevention is very important.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

scholarly journals Descemet membrane suturing to manage recurrent graft detachment in a patient with Descemet membrane endothelial keratoplasty on failed penetrating keratoplasty

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Zahra Ashena ◽  
Thomas Hickman-Casey ◽  
Mayank A. Nanavaty
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Anterior Segment ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Ocular Coherence Tomography ◽  
Corrected Visual Acuity ◽  
Intracameral Injection ◽  
History Of

A 65-year-old patient with history of keratoconus, mild cataract and penetrating keratoplasty over 30 years ago developed corneal oedema subsequent of graft failure with best corrected visual acuity (BCVA) of counting fingers. He underwent a successful cataract surgery combined with a 7.25 mm Descemet’s Membrane Endothelial Keratoplasty (DMEK) with Sodium Hexafluoride (SF6) gas. His cornea remained oedematous inferiorly at 4 weeks, despite two subsequent re-bubbling due to persistent DMEK detachment inferiorly. This was managed by three radial full thickness 10-0 nylon sutures placed in the inferior cornea along with intracameral injection of air. Following this, his anterior segment ocular coherence tomography (OCT) confirmed complete attachment of the graft, and the sutures were removed 4 weeks later. Unaided visual acuity was 20/63 and BCVA was 20/32 after 8 months. DMEK suturing can be helpful in persistent DMEK detachments, which is refractory to repeated re-bubbling due to uneven posterior surface of previous PK.

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