1/28. Acute follicular conjunctivitis caused by adenovirus type 34. PURPOSE: Adenovirus type 34 belongs to adenovirus subgenus B. The prototype virus of adenovirus 34 was isolated from a renal transplant recipient. However, no case of acute conjunctivitis caused by adenovirus 34 has been reported. Recently, we encountered two cases of acute follicular conjunctivitis in which adenovirus 34 was isolated. methods: The clinical isolates were identified by the standard neutralization test. The sequences of seven hypervariable regions in the hexon protein of these cases were compared with those of several prototype strains of adenovirus subgenus B. RESULTS: The cases were middle-aged, 34 and 41 years old, and male, and they exhibited moderate conjunctivitis with upper respiratory tract symptoms. Isolates from cell culture were identified as adenovirus 34 by NT. The mean homology rate (percentage of total number of coincident amino acids in the total length of amino acids in seven hypervariable regions) between clinical isolates and the adenovirus 34 prototype was 96.5%; in contrast, those between clinical isolates and the prototypes of adenovirus 11, adenovirus 14, and adenovirus 35 were 55.6%, 66.7%, and 57.9%, respectively. The results of conventional serotyping by neutralization test were confirmed by these values. CONCLUSIONS: These results indicate that adenovirus 34 may induce acute conjunctivitis in immunocompetent subjects and that special attention should be paid to adenovirus 34 as a causative agent for adenoviral conjunctivitis. ( info) |
2/28. The surgical treatment of molluscum contagiosum in a pediatric AIDS patient. molluscum contagiosum (MC) has arisen as an opportunistic pathogen in human immunodeficiency virus (hiv) disease. Recent reports have focused on the presentation of MC in adults who are hiv positive. The authors describe MC in a pediatric patient with acquired immmune deficiency syndrome. This particular patient showed the same atypical lesion morphology, distribution, and chronic course that is seen in the adult hiv patient. As in the adult patient, treatment in the pediatric patient also remains challenging, with limited success of traditional treatment modalities. The authors were able to achieve long-term remission and an excellent cosmetic result through meticulous superficial surgical excision of the patient's MC lesions. ( info) |
3/28. Molecular evidence of ocular Epstein-Barr virus infection. Ocular manifestations have been attributed to the Epstein-Barr virus (EBV), largely on the basis of seroepidemiologic data. Two patients who developed conjunctival disease as the presenting feature of EBV infection are reported, each confirmed by in situ hybridization of EBV genome in affected tissue biopsy specimens. Recognition of EBV-induced ocular disease as an initial presentation of clinical EBV infection is important to the practitioner because of the ubiquitous nature of this herpesvirus. ( info) |
4/28. genome typing of adenovirus type 34 isolated in two cases of conjunctivitis in Sapporo, japan. Two cases of conjunctivitis caused by adenovirus type 34 (Ad34) are reported. The isolates were identified as Ad34 by the neutralization test and the PCR-sequence method of the hexon gene but as Ad14 by PCR-restriction fragment length polymorphism analysis. The genome types of these two isolates were identical to that of Ad34a. ( info) |
| BACKGROUND: Infective conjunctivitis is common and mostly responds well to supportive management and/or empiric antibiotic treatment. At times the differential diagnosis includes more serious conditions that potentially threaten vision. recurrence and treatment failures are relatively common. OBJECTIVE: To outline the usual clinical appearance of conjunctivitis and its management. To explore the clinical appearance (with the help of case studies) of conditions that have been mistaken for conjunctivitis, and to consider some of the conditions that may coexist that contribute to recurrence and nonresponsiveness. DISCUSSION: Empiric treatment for presumed bacterial conjunctivitis remains an appropriate course of action. Care must be taken in certain groups who are at high risk of complications. Careful review of the clinical appearance and consideration of other possible diagnoses is mandatory in nonresponding patients. ( info) |
6/28. Ocular involvement in an outbreak of herpes gladiatorum. An epidemic of herpes simplex virus type 1 occurred in 60 of 175 wrestlers (34%) attending a four-week intensive training camp. Five of these 60 patients (8%) developed ocular involvement that included follicular conjunctivitis, blepharitis, and phlyctenular disease. Cultures of the conjunctiva and eyelid vesicles were positive for herpes simplex virus type 1 in four of the five patients with ocular disease. The viral isolates were compared by restriction-endonuclease analysis, which disclosed that three of the four isolates were the same strain. None of the patients had corneal involvement and there has been no evidence of viral recurrence to date. herpes simplex virus type 1 is a health risk for wrestlers, and ocular infections are part of the clinical spectrum. Prompt diagnosis and appropriate management of the outbreak may reduce the severity of the outbreak transmission. ( info) |
7/28. Adenovirus pneumonia with severe sequelae in an immunocompetent adult. Notable complications from adenovirus pneumonia in healthy adults are rare. We report a well-documented case of adenovirus type 3 infection in a previously well adult woman that resulted in severe pulmonary complications as well as self-limited ocular, hepatic, and gastrointestinal abnormalities. ( info) |
8/28. Concomitant oculoglandular and ulceroglandular fever due to herpes simplex virus type I. herpes simplex virus is a commonly encountered infectious agent in clinical practice. The syndromes with which it is usually associated are well described and generally easily recognized. This report documents that two uncommon clinical syndromes, ulceroglandular fever and oculoglandular fever, may be caused by this virus. Our patient's case was even more unusual in that both conditions occurred simultaneously. ( info) |
9/28. Characterisation of hexon and fibre genes of a novel strain of adenovirus involved in epidemic keratoconjunctivitis. AIMS: To characterise a novel strain (M86) of adenovirus (Ad) involved in epidemic keratoconjunctivitis (EKC). methods/RESULTS: The virus strain was neutralised by antisera to both Ad35 and Ad11. Restriction endonuclease analysis of genomic dna showed 98% and 88% homology with Ad11 and Ad35, respectively. The deduced amino acid sequence of the hypervariable regions of (HVRs) of the hexon gene showed a higher homology with Ad35 (94.4%) than with Ad11 (83.7%). However, it was 100% homologous to Ad35 in HVRs 1, 2, 3, and 6 and to Ad11 in HVRs 4 and 6. In the fibre knob, the isolate was more homologous to Ad11 (99.4%) than to Ad35 (29.1%). CONCLUSION: This novel strain of adenovirus showed similarities with both Ad11 and Ad35. The isolation of a novel strain like Ad35 11 is important because of its association with EKC. ( info) |
10/28. Ocular vaccinia following exposure to a smallpox vaccinee. PURPOSE: To describe the presentation and management of the first identified case of ocular vaccinia infection associated with the current smallpox vaccination program. DESIGN: Case report. methods: vaccinia virus was isolated by cell culture of a conjunctival swab. Direct staining with fluorescein isothiocyanate-labeled vaccinia antibody and polymerase chain reaction testing confirmed the diagnosis. RESULTS: In February 2003, a 26-year-old woman developed right preseptal cellulitis and blepharoconjunctivitis following contact with a vaccinated member of the military. The preseptal cellulitis resolved with antibacterial therapy, and the conjunctival infection was treated successfully with a 14-day course of topical trifluridine and a single dose of intravenous vaccinia immune globulin. CONCLUSIONS: To facilitate rapid diagnosis and appropriate treatment, clinicians must maintain a high index of suspicion for ocular smallpox vaccine-associated adverse reactions in vaccine recipients and their close contacts. ( info) |