1/21. Resolution of microsporidial sinusitis and keratoconjunctivitis by itraconazole treatment.PURPOSE: To report successful treatment of ocular infection caused by the microsporidium encephalitozoon cuniculi in a person with acquired immunodeficiency syndrome (AIDS) and nasal and paranasal sinus infection. METHOD: Case report. RESULTS: Microsporidial infection in a person with AIDS and with chronic sinusitis and keratoconjunctivitis was diagnosed by Weber modified trichrome stain and transmission electron microscopy. Symptoms completely resolved with itraconazole treatment (200 mg/day for 8 weeks) after albendazole therapy (400 mg/day for 6 weeks) was unsuccessful. CONCLUSION: itraconazole can be recommended in ocular, nasal, and paranasal sinus infection caused by E. cuniculi parasites when treatment with albendazole fails.- - - - - - - - - - ranking = 1keywords = conjunctivitis (Clic here for more details about this article) |
2/21. Ocular linguatuliasis in ecuador: case report and morphometric study of the larva of Linguatula serrata.Linguatula serrata is a pentastomid, a cosmopolitan parasite belonging to the Phylum pentastomida. humans may act as an intermediate or accidental definitive host of this parasite, manifesting the nasopharyngeal or visceral form, with the latter having been described more frequently. The occurrence of ocular linguatuliasis is extremely rare, but it has been reported in the united states and israel. The objective of the present paper was to report the first case of ocular linguatuliasis in ecuador and to extend the morphologic study of L. serrata by morphometric analysis. The patient studied was a 34-year old woman from Guayaquil, ecuador who complained of ocular pain with conjunctivitis and visual difficulties of two-months duration. Biomicroscopic examination revealed a mobile body in the anterior chamber of the eye. The mobile body was surgically removed. The specimen was fixed in alcohol, cleared using the technique of Loos, stained with acetic carmine, and mounted on balsam between a slide and a coverslip. It was observed with stereoscopic and common light microscopes in combination with an automatic system for image analysis and processing. The morphologic and morphometric characteristics corresponded to the third-instar larval form of L. serrata. To our knowledge, ocular linguatuliasis has not been previously described in south america, with this being the first report for ecuador and south america. The present study shows that computer morphometry can adequately contribute both to the morphologic study and to the systematic classification of Pentastomids, and L. serrata in particular.- - - - - - - - - - ranking = 0.2keywords = conjunctivitis (Clic here for more details about this article) |
3/21. Palpebral myiasis in a Danish traveler caused by the human bot-fly (Dermatobia hominis).PURPOSE: To demonstrate a case of palpebral myiasis caused by Dermatobia hominis in a Dane traveling in the Brazilian rain forest. methods: Surgical removal and histological examination. RESULTS: Within three weeks after returning from the Brazilian rain forest, the patient developed a localized swelling of the left upper eyelid and follicular conjunctivitis. A funnel containing a larva was found between the cilia. The larva was excised together with surrounding inflammatory tissue. The clinical findings as well as zoological and pathological examinations indicated a case of palpebral myiasis caused by Dermatobia hominis. The larva was removed in its third stage four weeks from symptom debut. CONCLUSIONS: Infestation with Dermatobia hominis should be suspected when itching and red swelling of the lid are present in patients who have been to Central and south america.- - - - - - - - - - ranking = 0.2keywords = conjunctivitis (Clic here for more details about this article) |
4/21. Resolution of microsporidial keratoconjunctivitis in an AIDS patient treated with highly active antiretroviral therapy.PURPOSE: To report the outcome of microsporidial keratoconjunctivitis in a patient with acquired immunodeficiency syndrome (AIDS) after highly active antiretroviral therapy without any specific treatment for microsporidiosis. methods: Case report. A 42-year-old woman diagnosed with AIDS and severe immunodepression (CD4 of 9 cells/mm(3) and viral load of 460,000/mm(3)), antiretroviral naive, presented with cerebral toxoplasmosis and microsporidial keratoconjunctivitis in the right eye documented by conjunctival scraping and electron microscopy. RESULTS: The patient was treated with a combination of indinavir, stavudine, and lamivudine, besides sulfadiazine and pyrimethamine. No specific treatment for the microsporidial keratoconjunctivitis was attempted. One month later, the keratoconjunctivitis had disappeared. CONCLUSION: This case suggests that microsporidial keratoconjunctivitis in the setting of AIDS and severe immunodepression can be effectively managed with highly active antiretroviral therapy alone.- - - - - - - - - - ranking = 1.8keywords = conjunctivitis (Clic here for more details about this article) |
5/21. Extraocular muscle cysticercosis presenting as Brown syndrome.PURPOSE: Report of a case of acquired Brown syndrome caused by infestation of the superior oblique muscle by cysticercus cellulosae. METHOD: Case seen in a referral practice. A 20-year-old man presented with recurrent attacks of conjunctivitis and diplopia in upgaze. Clinical examination of ocular motility established a diagnosis of acquired Brown syndrome of the right eye. Computed tomography of the right orbit unequivocally established the diagnosis of superior oblique muscle cysticercosis. The patient was started on systemic steroids and albendazole in the prescribed doses for a month. RESULT: Serial computed tomography scans of the orbit revealed resolution of the cystic lesion after a month. Clinically, although there was restoration of ocular motility in upgaze, mild restriction of movement of the right eye in levoelevation persisted. However, the patient was symptomatically better with amelioration of the recurrent conjunctivitis and diplopia in primary gaze. CONCLUSION: Extraocular muscle cysticercosis should be considered in the differential diagnosis of acquired motility disorder. The presentation of extraocular muscle cysticercosis as an acquired Brown syndrome is unusual. Response to medical therapy was satisfactory.- - - - - - - - - - ranking = 0.4keywords = conjunctivitis (Clic here for more details about this article) |
6/21. Microsporidial keratoconjunctivitis in a healthy contact lens wearer without human immunodeficiency virus infection.PURPOSE: To present a rare case of microsporidial keratoconjunctivitis in an otherwise healthy contact lens wearer without human immunodeficiency virus infection who responded to treatment with systemic albendazole and topical fumagillin. DESIGN: Interventional case report. METHOD: A cornea epithelial scraping from a man with unilateral keratoconjunctivitis previously treated with topical steroids was evaluated by modified trichome staining. MAIN OUTCOME MEASURES: The patient was evaluated for his symptoms, visual acuity, clinical observations, and pathologic examination of corneal scrapes. RESULTS: Modified trichome staining of an epithelial corneal scraping revealed pinkish to red organisms characteristic of microsporidia. Results of a human immunodeficiency virus (hiv) enzyme-linked immunosorbent assay test were negative. The symptoms of ocular discomfort and clinical signs of keratoconjunctivitis resolved after 2 months of treatment with albendazole and topical fumagillin. CONCLUSIONS: Ocular infection with microsporidia, although classically occurring in patients with hiv infection, may occur rarely in healthy individuals, especially if previously treated with systemic immune suppression or topical steroids. Microsporidial keratoconjunctivitis should be considered in the differential diagnosis of a contact lens wearer with atypical multifocal diffuse epithelial keratitis.- - - - - - - - - - ranking = 1.6keywords = conjunctivitis (Clic here for more details about this article) |
7/21. Microsporidial keratoconjunctivitis after HAART.A 44-year-old man presented with bilateral punctate corneal epitheliopathy complaining of worsening discomfort and photophobia over the previous several days. He was hiv positive, had a recent CD4 count of 4 x 10(6), and had started on highly active antiretroviral therapy (HAART) 14 days prior. Failure to respond to lubricant therapy with worsening of the epitheliopathy over the following week led to corneal biopsy and diagnosis of corneal microsporidiosis. Investigations revealed that he remained anergic and that his CD4 count had not changed. However, his viral load had decreased by at least 0.9 log10 units since HAART intiation. Therapy with albendazole led to complete resolution of his pre-existing symptoms of nasal congestion and epistaxis, as well as all recently occurring ocular signs and symptoms. It was concluded that the microsporidiosis was a pre-existing opportunistic infection, whose presence was unmasked by a form of immune restoration induced by HAART.- - - - - - - - - - ranking = 0.8keywords = conjunctivitis (Clic here for more details about this article) |
8/21. Successful treatment of ocular leishmaniasis.PURPOSE: To report successful treatment of a case of ocular leishmaniasis with combined stibogluconate and allupurinol. METHOD: A 32-year-old physician developed a non-tender reddish chalazion like lesion in his right lower lid, associated with conjunctivitis and nodular episcleritis. biopsy of the lesion in his eyelid and conjunctiva disclosed a dense inflammatory response including histiocytes containing typical leishmania organisms. RESULT: Therapy with stibogluconate, both intralesional and intramuscular, was initiated with some improvement. However recurrence of the lesion occurred. Systemic retreatment with combined stibogluconate and allupurinol led to complete healing of the lesion. CONCLUSION: Ocular leishmaniasis is a rare and potentially blinding disorder. Combined stibogluconate and allupurinol may be an effective therapy in such cases.- - - - - - - - - - ranking = 0.2keywords = conjunctivitis (Clic here for more details about this article) |
9/21. Microsporidial keratoconjunctivitis in a healthy patient with a history of LASIK surgery.PURPOSE: To describe a case of microsporidia corneal infection in a hiv-negative patient who did not wear contact lenses. METHOD: Case report and review of literature. RESULTS: This is the first case report of a human immunodeficiency virus-negative individual, a non-contact lens wearer, with microsporidia infection. CONCLUSION: microsporidia keratoconjunctivitis may occur in healthy subjects with no antecedent contact lens wear.- - - - - - - - - - ranking = 1keywords = conjunctivitis (Clic here for more details about this article) |
10/21. The first human case in mexico of conjunctivitis caused by the avian parasite, Philophthalmus lacrimosus.Species of Philophthalmus parasitize primarily the eyes of wild and domestic birds. A variety of mammals, including humans, occasionally serve as the intermediate as well as the definitive hosts for this parasite, although human cases are extremely rare. Here, we report a case of human conjunctivitis caused by an infection with Philophthalmus sp. in mexico. The patient was a 31-yr-old male who visited an ophthalmologist in Los Mochis, Sinaloa, mexico, because of a foreign-body sensation in his left eye for 2 mo. A small live parasite was found in the connective tissue of the bulbar conjunctiva and was removed surgically under local anesthesia under ophthalmoscopic observation. The parasite was identified morphologically as Philophthalmus lacrimosus Braun, 1902. This is the first case of human philophthalmosis in mexico and, to our knowledge, the first human case of P. lacrimosus infection in the world.- - - - - - - - - - ranking = 1keywords = conjunctivitis (Clic here for more details about this article) |
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