1/23. Epithelial infectious crystalline keratopathy.PURPOSE: To report 2 cases of epithelial infectious crystalline keratopathy. methods: Two patients (2 eyes) with significant meibomitis presented with minimal inflammation and plaque-like lesions on the corneal surface made of fine crystalline structures. Corneal scrapings of these lesions were performed for microbiological evaluation. The patients were treated with topical ciprofloxacin and artificial tears. RESULTS: Smear examination of the corneal scrapings revealed numerous bacteria and keratinized epithelial cells with no inflammatory cells. culture showed a significant growth of staphylococcus epidermidis and corynebacterium species in the first case and Pseudomonas aeroginosa in the second case. The response to treatment was poor, with recurrence of the crystalline lesion. CONCLUSION: Infectious crystalline keratopathy lesions may involve the epithelium and occur on the corneal surface.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/23. Chronic postoperative endophthalmitis due to pseudomonas oryzihabitans.PURPOSE: To report a case of chronic postoperative endophthalmitis caused by the gram-negative bacterium Pseudomonas oryzihabitans.DESIGN: Interventional case report.methods: A 77-year-old man was referred to our service for nonpainful uveitis in the right eye accompanied by increased intraocular pressure of 2 years' duration with onset 4 months after uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens implantation. The uveitis partially responded to topical corticosteroid therapy but was recurrent with tapering of steroids. An anterior chamber tap and vitreous biopsies sent for cultures were negative. Owing to the persistence of inflammation despite intraocular vancomycin injection, the lens implant and capsule were removed and culture of the latter revealed the bacterium P. oryzihabitans.RESULTS: There was no recurrence of inflammation after removal of the lens implant and capsule.CONCLUSIONS: Unlike other gram-negative organisms, which are associated with poor outcomes, P. oryzihabitans may masquerade as chronic uveitis because of its low virulence.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
3/23. De novo pulmonary capillary hemangiomatosis occurring rapidly after bilateral lung transplantation.A 45-year-old woman experienced diffuse bilateral pulmonary capillary hemangiomatosis within 3 months after bilateral lung transplantation. The donor was a 41-year-old man with excellent lung function and without histologic or macroscopic pulmonary lesions at the time of retrieval. This case supports the theory that persistent infection or inflammation may be an inciting factor in uncontrolled angiogenesis, leading ultimately to diffuse pulmonary capillary hemangiomatosis.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/23. Ocular complications associated with the use of cosmetic contact lenses from unlicensed vendors.PURPOSE: To call attention to the unauthorized sale of cosmetic contact lenses, resulting in ocular complications.DESIGN Observational case report. methods: Retrospective, observational, clinical practice setting. RESULTS: Six patients (five female and one male) were seen urgently for acute eye pain and redness after wearing cosmetic plano contact lenses. None of the patients had previously worn a contact lens or spectacle correction. None of the lenses were dispensed by eye care professionals. One patient developed pseudomonal keratitis, ultimately requiring penetrating keratoplasty for visual rehabilitation. CONCLUSIONS: Colored contact lenses are being dispensed without a prescription or fitting from unlicensed vendors, such as cosmetics, convenience, and accessory stores. Lenses are sold individually and without care instructions. Consequently, uninformed lens wearers are experiencing acute, vision-threatening infections and inflammation.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/23. carcinoma of temporal bone presenting as malignant otitis externa.A 69-year-old man presented with a three-month history of otalgia and tenderness of the right ear and a one-week history of a painful right parotid swelling. Examination revealed granulation tissue in the right ear canal with normal looking tympanic membranes and a parotid abscess. Repeated biopsies from the ear canal and parotid showed non-specific inflammation. Repeated cultures from both areas grew Ps. aeruginosa. The patient's condition improved following three weeks of intensive treatment for malignant otitis externa only to relapse five weeks after the end of treatment. He received a second course, only to improve temporarily. He developed a right facial nerve palsy five weeks after he was first seen, followed four months later by palsies of all cranial nerves except the olfactory, before dying, seven months after his first appointment. The radiological, histological and post-mortem findings are discussed.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/23. Pseudomonas sternoclavicular pyarthrosis.Most cases of Pseudomonas pyarthrosis affecting the sternoclavicular joint have been reported in immunosuppressed intravenous drug users. We report a case of Pseudomonas pyarthrosis in a man who was otherwise immunocompetent, except for his age. A 66-year-old white man presented to the clinic with a 1-month history of right-sided shoulder and arm pain associated with swelling of the upper part of the chest in the region of the right sternoclavicular joint. The chest radiograph revealed opacity in the right superior mediastinum. Computed tomography scan of the chest confirmed a mass in the right sternoclavicular region with associated osteolysis of the clavicular head. A needle biopsy of the mass was negative for malignancy. An open biopsy specimen showed evidence of chronic inflammation without evidence of malignancy, and culture of the tissue grew pseudomonas aeruginosa. The patient's symptoms improved after extensive incision and drainage of the affected area followed by treatment with antibiotics for 6 weeks.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
7/23. Facial cellulitis associated with pseudomonas aeruginosa complicating ophthalmic herpes zoster.cellulitis is a rare and severe soft-tissue infection characterized by acute, diffuse, spreading inflammation, often associated with systemic symptoms such as malaise and fever. Surgery of the head and neck, dental infections, sinusitis, upper respiratory tract infections, and trauma are the most common portal of entry for pathogens in facial cellulitis. A very unusual case complicating an ophthalmic herpes zoster in a 74-year-old woman was observed at the department of dermatology, Cagliari University (italy). culture of skin swabs showed growth of numerous Gram-negative bacilli, further identified as pseudomonas aeruginosa. Therapy with intravenous ciprofloxacin was promptly instituted on the basis of the culture and sensitivity report. She was initially treated with daily drainage and twice-daily topical fusidic acid. The lesion completely resolved in 4 weeks, and no general complications or recurrence have been observed for 6 months. Early recognition and management of facial cellulitis is mandatory to avoid serious and generalized complications. pseudomonas aeruginosa is rarely reported in facial cellulitis; there are apparently no reports of this infection occurring as a complication of ophthalmic herpes zoster. Herpetic damage of the anatomic barrier as well as impairment of defense mechanisms because of decompensated diabetes mellitus may have facilitated the colonization and proliferation of this opportunistic pathogen in our patient.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
8/23. Case report: greater meningeal inflammation in lumbar than in ventricular region in human bacterial meningitis.Differences in the composition of ventricular and lumbar cerebrospinal fluid (CSF) based on single pairs of samples have previously been described. We describe a patient that developed post-surgical recurrent meningitis monitored by daily biochemical and bacteriological CSF analysis, simultaneously withdrawn from lumbar space and ventricles. A 20-year-old Caucasian man was admitted to the ICU after a resection of a chordoma that extended from the sphenoidal sinus to the anterior face of C2. CSF was continuously leaking into the pharyngeal cavity after surgery, and three episodes of recurrent meningitis, all due to pseudomonas aeruginosa O12, occurred. Our case showed permanent ventricular-to-lumbar CSF gradients of leukocytes, protein and glucose that were increased during the acute phase of meningitis, with the greatest amplitude being observed when bacteria were present in both ventricular and lumbar CSF. This might suggest a greater extent of meningeal inflammation in the lumbar than in the ventricular region. Our case also showed that the increase in intravenous antibiotics (cefepim from 8 to 12 g/day and ciprofloxacine from 1.2 to 2.4 g/day) led to an increase in concentration in plasma but not in CSF.- - - - - - - - - - ranking = 5keywords = inflammation (Clic here for more details about this article) |
9/23. Subpalpebral lavage antibiotic treatment for severe infectious scleritis and keratitis.OBJECTIVE: To report the subpalpebral lavage therapy for the treatment of infectious scleritis and keratitis. METHOD: Six patients were admitted for treatment of severe infectious scleritis and keratitis and were initiated on the subpalpebral lavage system after showing no improvement with topical fortified antibiotics. A continuous antibiotic lavage was applied until clinical sterility was achieved and topical steroids were gradually added to control concomitant inflammation. RESULTS: All 6 patients had resolution of their infections and achieved a stable ocular surface with no inflammation. One patient required a corneal transplant for active inflammation and corneal thinning, 1 had a transplant for a dense central corneal scar, and 1 patient underwent corneal transplant and cataract extraction. One case was a Pseudomonas keratitis in a blind eye, which rapidly resolved and has remained stable. Four patients required additional surgeries, which included 3 corneal transplants, 2 cataract extractions, and 1 glaucoma aqueous shunt. CONCLUSION: Continuous irrigation of the eye can improve scleral penetration of antibiotics. Subpalpebral lavage provides continuous irrigation and may be effective in the treatment of infectious scleritis of a variety of etiologies.- - - - - - - - - - ranking = 3keywords = inflammation (Clic here for more details about this article) |
10/23. Nicolau syndrome following intramuscular diclofenac administration: a case report.Nicolau syndrome (livedoid dermatitis) is a rare adverse reaction of a still largely unidentified pathogenesis at the site of intramuscular drug injection. The typical presentation is pain around the injection site soon after injection, followed by erythema, livedoid patch, haemorrhagic patch, and finally necrosis of skin, subcutaneous fat, and muscle tissue. The phenomenon has been related to the administration of a variety of drugs, including non-steroidal anti-inflammatory drugs, corticosteroids, and penicillin. We report a case of Nicolau syndrome following an intramuscular injection of diclofenac. The large ulceration over the right buttock was positive for pseudomonas aeruginosa, and histology revealed subcutaneous fat necrosis and non-specific inflammation with no evidence of malignancy or vasculitis. The lesion required multiple debridements and a partial-thickness skin graft. Subcutaneous injection, rather than intramuscular injection, was found to be a determining factor in this case. Clinicians must be cautious in the use of proper injection procedures, including appropriate needle length, in order to minimise complications.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
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