21/58. listeria monocytogenes-induced endogenous endophthalmitis: bioultrasonic findings.PURPOSE: To report bioultrasonic findings in listeria monocytogenes-induced endophthalmitis (LMIE) that have not been described previously. DESIGN: Interventional case report. methods: To rule out intraocular tumor, ultrasound biomicroscopy was performed in a patient referred for a 2-day history of uveitis with elevated intraocular pressure, dark hypopyon, and pigment dispersion in the anterior chamber. RESULTS: Ultrasound biomicroscopy examination showed increased iris thickness with rarefaction of tissue and irregular echogenicity as well as iris pigment epithelial detachment. A small choroidal detachment was also detected. The anterior chamber and vitreous sample confirmed the LMIE diagnosis. CONCLUSIONS: The detection of both pigment epithelial detachment and changes in the iris tissue could explain why black hypopyon frequently develops in LMIE with significant pigment dispersion in some cases.- - - - - - - - - - ranking = 1keywords = gene (Clic here for more details about this article) |
22/58. Histological examination of an eye with endogenous aspergillus endophthalmitis treated with oral voriconazole: a case report.PURPOSE: To report the histological findings of an eye with severe aspergillus endophthalmitis after oral treatment with voriconazole. methods. Case report. RESULTS: Histopathological examination revealed no fungal elements in choroidal or retinal vessels. The hyphae were mainly restricted to the vitreal side of the preretinal inflammatory infiltrate. Since the treatment with voriconazole had not been completed at the time of enucleation, the clinical course with potential further limitation or regression of the lesion remains unsettled. CONCLUSIONS: Endogenous aspergillus endophthalmitis is a devastating condition often associated with immunodeficiency. The pathogenesis of this entity implies the primary invasion of choroidal and retinal vessels. The lack of antifungal drugs with high blood-ocular permeability results in an extremely poor visual prognosis. Our histological examination indicates promising activity and ocular penetration of the new antifungal agent voriconazole.- - - - - - - - - - ranking = 0.2keywords = gene (Clic here for more details about this article) |
23/58. Pseudohypopyon following intravitreal triamcinolone acetonide injection.OBJECTIVE: To report a case of a pseudohypopyon that developed after intravitreal injection of triamcinolone acetonide for choroidal neovascularization from age-related macular degeneration. methods: Observational case report. RESULTS: A 62-year-old woman received an intravitreal injection of triamcinolone acetonide for the treatment of a choroidal neovascular membrane that developed as a result of age-related macular degeneration. A layer of yellowish deposits was observed in the anterior chamber 1 day after the injection. The patient denied any pain or reduced vision, and there was no redness noted on examination. The deposits cleared spontaneously on the fourth postoperative day. CONCLUSIONS: Pseudohypopyon may develop after intravitreal injection of triamcinolone acetonide. Distinguishing this from a true hypopyon is important because the treatment and prognosis are very different for the two conditions.- - - - - - - - - - ranking = 0.4keywords = gene (Clic here for more details about this article) |
24/58. Ocular and systemic determination of IL-1 beta and tumour necrosis factor in a patient with ocular inflammation.cytokines such as interleukin-1 beta (IL-1 beta) and tumour necrosis factor (TNF) may play an important role in ocular inflammation. We studied a patient with clinical features of sympathetic ophthalmia secondary to previous penetrating ocular injuries, and compared the ocular and systemic levels of IL-1 beta and TNF to control serum, and correlated these findings to histopathological sections of the patient's eye. histology showed the presence of a diffuse chronic inflammatory infiltrate within the choroid and in a perivascular distribution in the retina. The significantly elevated ocular and systemic levels of IL-1 beta and TNF suggest that there is not only a localized ocular response but a systemic response as well. The presence of IL-1 beta TNF may play a role in the pathogenesis of ocular inflammation once the blood ocular barrier has been breached and ocular antigens have been exposed to the systemic immune system.- - - - - - - - - - ranking = 0.2keywords = gene (Clic here for more details about this article) |
25/58. endophthalmitis caused by klebsiella species.PURPOSE: To investigate clinical settings, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by klebsiella species. DESIGN: Retrospective case series. methods: Record review of patients with endophthalmitis caused by klebsiella (1984 through 2003). RESULTS: Clinical settings included cataract surgery (one eye), trauma (two), perforated corneal ulcer (one), and endogenous associated with hepatic abscess (one). Pretreatment vision was hand motions or better in four eyes (80%). Initial treatment was enucleation (one eye), pars plana vitrectomy (two), and vitreous tap and injection (two); intravitreal antibiotics were administered to all nonenucleated eyes. klebsiella was sensitive to one or more antibiotics administered initially in all cases. In nonenucleated eyes, final acuity was >or=20/400 in two, 1/200 in one, and light perception in one. CONCLUSION: Despite treatment with appropriate antibiotics, endophthalmitis caused by klebsiella species is associated with generally poor visual outcomes.- - - - - - - - - - ranking = 0.2keywords = gene (Clic here for more details about this article) |
26/58. Management of endogenous fungal endophthalmitis with voriconazole and caspofungin.PURPOSE: Voriconazole, a new generation triazole, has been shown to achieve therapeutic intraocular levels after oral administration. Caspofungin is the first approved agent from a new class of antifungals, the echinocandins. This series describes experience at two centers using these novel antifungals to treat endogenous fungal endophthalmitis. DESIGN: Retrospective review. methods: Treatment of five patients with Candida endophthalmitis are reviewed. Postmortem intraocular voriconazole concentrations on a sixth patient are presented as well. RESULTS: All patients had systemic cultures positive for Candida species. Three patients had prompt resolution of intraocular mycosis with intravenous and oral voriconazole, caspofungin, or both. The fourth patient with bilateral disease responded well to i.v. voriconazole and caspofungin but had a recurrence when discharged on oral voriconazole and i.v. caspofungin. This patient had a bowel resection with an ileostomy; therefore, absorption of oral voriconazole may have been inadequate. Bilateral amphotericin b intravitreal injection ultimately treated this patient. The fifth patient received 100 microg/0.1 ml of intravitreal voriconazole (final vitreous concentration approximately 25 microg/ml) followed by oral voriconazole and responded favorably. Our sixth patient had multisystem failure and passed away 1 week after initiating intravenous voriconazole for non-ocular candidemia. Postmortem HPLC analysis of the aqueous and vitreous revealed voriconazole concentrations of 1.52 microg/ml and 1.12 microg/ml, respectively (MIC90 of candida albicans is 0.06 microg/ml). CONCLUSIONS: Voriconazole and caspofungin appear to be powerful weapons to add to the existing armamentarium against fungal endophthalmitis. Further studies are warranted to define precisely the role of these new agents alone or in combination with other antifungals.- - - - - - - - - - ranking = 0.2keywords = gene (Clic here for more details about this article) |
27/58. endophthalmitis caused by enterococcus mundtii.enterococcus mundtii has rarely been isolated from environmental or human sources. We report the identification of E. mundtii as a pathogen of human infectious disease by dna sequencing of 16S rRNA and sodA genes in a case of endophthalmitis developed in a 66-year-old immunocompetent gardener.- - - - - - - - - - ranking = 0.2keywords = gene (Clic here for more details about this article) |
28/58. Delayed-onset streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation.BACKGROUND: To report a case of delayed-onset streptococcus pyogenes endophthalmitis following implantation of an Ahmed glaucoma valve. CASE: A 10-year-old patient presented with acute endophthalmitis 1 year after Ahmed glaucoma valve implantation. OBSERVATIONS: The conjunctiva and Tenon's capsule over the valve plate had been penetrated by one of the polypropylene fixation sutures. The valve was removed, and pars plana vitrectomy was performed. Vitreous specimens and removal of the discharge over the plate revealed streptococcus pyogenes. CONCLUSIONS: This is the first documented case of streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation. We think the conjunctival buttonhole caused by the polypropylene suture provided an entry site for the infection.- - - - - - - - - - ranking = 1.4keywords = gene (Clic here for more details about this article) |
29/58. achromobacter xylosoxidans endophthalmitis diagnosed by polymerase chain reaction and gene sequencing.PURPOSE: To report a patient with achromobacter xylosoxidansendophthalmitis that was diagnosed using polymerase chain reaction and gene sequencing. methods: Case report. A patient with culture-negative endophthalmitis underwent an anterior chamber tap. polymerase chain reaction was performed on the aqueous sample using the 16S ribosomal dna primer set to detect and amplify bacterial dna. The amplified dna was sequenced and compared to archived sequences in a gene library using the BLAST search program. RESULTS: A 214-base pair gene sequence was amplified and matched with the gene sequence for A. xylosoxidans. Antimicrobial treatment was instituted with resolution of hypopyon, anterior chamber cells, and vitreous cells one month after treatment. CONCLUSIONS: polymerase chain reaction of 16S rDNA combined with gene sequencing may be an alternative method of diagnosing culture-negative bacterial endophthalmitis.- - - - - - - - - - ranking = 1.8keywords = gene (Clic here for more details about this article) |
30/58. listeria monocytogenes endophthalmitis.Listeria endophthalmitis developed in an otherwise healthy woman. Early identification of the microorganism after anterior chamber paracentesis and aggressive treatment with specific antibiotics through the intravitreal route resulted in complete recovery of visual acuity.- - - - - - - - - - ranking = 0.8keywords = gene (Clic here for more details about this article) |
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