Azithromycin prophylaxis and treatment of murine toxoplasmosis

To evaluate the azithromycin effects alone and in combination with other agents in the prophylaxis and treatment of murine toxoplasmosis. A total of 280 BALB/c mice were included, and 2 x 103 Toxoplasma organisms of the RH strain Toxoplasma gondii strain ATCC50174 were given intraperitoneally to each mouse. In experiment one, 40 animals were given azithromycin 200 milligram/kilogram/daily for 3 days starting the day of inoculation, 40 mice were control. In experiment 2, the treatment was started 48 hours after inoculation and given daily for 3 days: one group received azithromycin 200 milligram/kilogram/day, the second group received pyrimethamine 25 milligram/kilogram/day, and the sulfadiazine 100 milligram/kilogram/day. The third group was control. In experiment 3, 7 groups of animals received one of the following [1] none, [2] azithromycin 200 milligram/kilogram/day, [3] pyrimethamine 25 milligram/kilogram/day and sulfadiazine 100 milligram/kilogram/day, [4] azithromycin and sulfadiazine, [5] azithromycin and pyrimethamine, [6] azithromycin with sulfadiazine and pyrimethamine, [7] sulfadiazine alone. Treatment was initiated 72 hours after inoculation for 3 days. The study was conducted at the Animal Care Facility of King Saud University, Riyadh, Kingdom of Saudi Arabia. Animals that received azithromycin simultaneously with inoculation survived, and all control animals died. All animals died in groups receiving single drug therapy. Animals treated with azithromycin and sulfadiazine showed a survival rate of 40%, sulfadiazine and pyrimethamine 40%, or azithromycin with sulfadiazine and pyrimethamine 95% [p<0.0001]. Azithromycin alone was found to be effective in the prophylaxis of murine toxoplasmosis. Combination therapy was effective in the treatment of murine toxoplasmosis

Successful prophyloxix of clostridium perfringens endophthalmitis

Our report describes a 30 year-old man, who sustained a penetrating injury with an intraocular foreign body. The patient underwent pars plana vitrectomy and removal of the intraocular foreign body. A vitreous biopsy culture grew Clostridium perfringens, The postoperative course was complicated by a fibrinous reaction in the anterior chamber that was controlled by frequent streoid eye drops. Two months after the procedure, visual acuity was 20/60 with no evidence of infection. The excellent outcome in this case supports prompt vitrectomy intervention and the removal of acute retained intraocular foreign bodies in the prophylactic treatment of C. perfringens endophthalmitis

Fungal endophthalmitis following penetrating ocular trauma

Fungal endophthalmitis following penetrating trauma is uncommon. When it does occur, it is usually associated with injury involving organic matter, as in the case presented here. An additional precipitating factor in this case was injudicious use of corticosteroids after the penetrating corneal laceration. Clinical features were typical of fungal endophthalmitis. Microscopic examination of stained vitreous specimens obtained at vitrectomy revealed yeast organisms. Treatment consisted of vitrectomy, intravitreal injection of amphotericin B, and oral ketoconazole. The treatment was successful and the patient's final visual acuity was 20/20

Current concepts in diabetic macular edema

Edema of the macula in diabetic patients is a frequent component of diabetic retinopathy, as well as a leading cause of loss of vision in this common disorder. The disease macular edema [ME] is subdivided into focal and diffuse. Many factors, both local and systemic, may contribute to the formation of diabetic ME. Several studies have shown that photocoagulation treatment of eyes with diabetic ME decreases the risk of visual loss. Early detection of asymptomatic diabetic patients with clinically significant ME is important for effective treatment. The results of the Early Treatment Diabetic Retinopathy Study [ETDRS] suggest that clinical signs of ME, rather than deterioration of visual acuity, are the important criteria in deciding whether and when to apply focal photocoagulation in persons with diabetes

Terson's syndrome

A patient with nonclearing vitreous hemorrhage, associated with intracranial bleeding complicating ruptured cerebral aneurysms [Tersons's syndrome] is presented. The patient underwent pars plana vitrectomy and his vision was restored

Vitrectomy and fluid/silicone oil exchange for retinal detachment due to Macular hole in high myopes

Seventeen eyes with retinal detachment due to macular hole associated with high myopia and significant staphyloma and chorioretinal atrophy at the posterior pole were treated successfully. Our method involves the use of an encircling band, pars plana vitrectomy, fluid/silicone oil exchange, internal drainage of subretinal fluid and prone positioning of the patient for 24 hours. Macular coagulation and macular buckling were not necessary. In all eyes the retina remained flat during follow-up periods ranging from 6 to 20 months