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Arq. bras. oftalmol ; 84(5): 474-480, Sept.-Oct. 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1339208


ABSTRACT Purpose: The aim of this study was to analyze patient data and the laboratory results of corneal samples collected from patients followed at the Ophthalmology Department, Hospital São Paulo, Brazil over a 30-year period, and correlate the analize with contact lens wearing. Methods: Corneal samples from patients diagnosed clinically with microbial keratitis between January 1987 and December 2016 were included in this study. Cultures that were positive for bacteria, fungi, and Acanthamoeba spp. were analyzed retrospectively. To ascertain if the number of patients with contact-lens-associated microbial keratitis (as a risk factor for microbial infection) changed over time, the analysis was divided into three decades: 1987-1996, 1997-2006, and 2007-2016. Information pertaining to patient gender and age, as well as type of organism isolated, were compared among these periods. Results: The corneal samples of 10.562 patients with a clinical diagnosis of microbial keratitis were included in the study, among which 1.848 cases were related to the use of contact lenses. The results revealed that the frequency of contact-lens-associated microbial keratitis increased over the last two decades. Overall, females had contact-lens-associated microbial keratitis more frequently (59.5%). Patients aged 19-40 years also had contact-lens-associated microbial keratitis more frequently in all study periods. Staphylococcus spp. and Pseudomonas spp. were the most frequent Gram-positive and Gram-negative bacteria, respectively, in the microbial keratitis groups. Among the fungal cases of microbial keratitis, filamentous fungi were the most frequent fungi over the entire study period, with Fusarium spp. being the most frequent fungi in the group with microbial keratitis not associated with contact lens wearing (p<0.001). Samples positive for Acanthamoeba spp. and Pseudomonas spp. were significantly correlated with contact-lens-associated microbial keratitis (p<0.001). Conclusions: Females and young adults aged 19-40 years exhibited the highest frequency of contact-lens-associated microbial keratitis in our study. Staphylococcus spp. and Fusarium spp. were the predominant bacteria and fungi, respectively, isolated from corneal samples. Pseudomonas spp. and Acanthamoeba spp. were significantly correlated with contact-lens-associated microbial keratitis in this study.

RESUMO Objetivo: O objetivo deste estudo foi analisar da dos epidemiológicos de pacientes e resultados laboratoriais para todas as amostras de córnea coletadas de pacientes atendidos no Departamento de Oftalmologia do Hospital São Paulo, Brasil, durante um período de 30 anos e correlacionar com o uso de lentes de contato. Métodos: Amostras de córnea de pacientes com diagnóstico clínico de ceratite microbiana (de janeiro de 1987 a dezembro de 2016) foram incluídas neste estudo. Resultados laboratoriais para culturas positivas para bactérias, fungos e Acanthamoeba spp. foram analisados retrospectivamente. Para verificar se o número de pacientes com ceratite microbiana associada à lente de contato, fator de risco para infecção microbiana, mudou ao longo do tempo, a análise foi dividida em três décadas: 1987-1996, 1997-2006 e 2007-2016. As informações incluindo o sexo do paciente, idade e tipo de organismo isolado foram comparadas entre os períodos. A análise estatística foi realizada no software SAS/STAT 9.3 e SPSS (v20.0). Resultados: Amostras de córnea de 10.562 pacientes com ceratite microbiana foram incluídas no estudo, das quais 1.848 foram relacionadas ao uso de lentes de contato. Os resultados revelaram que a frequência de ceratite microbiana associada à lente de contato aumentou nas últimas duas décadas analisadas. No geral, os homens compreendiam uma proporção maior do grupo ceratite microbiana não associada à lente de contato (CMNLC) (60,3%) e as mulheres eram mais frequentes no grupo ceratite microbiana associada à lente de contato (59,5%). Pacientes com idade entre 19 e 40 anos foram mais frequentemente observados no grupo ceratite microbiana associada à lente de contato em todos os períodos. Staphylococcus spp. foi a bactéria Gram-positiva mais frequentes, enquanto Pseudomonas spp. foi a bactéria Gram-negativa nos grupos ceratite microbiana. Entre os fungos ceratite microbiana, os fungos filamentosos foram os fungos mais frequentes durante todo o período do estudo, com Fusarium spp. sendo o mais frequente no grupo ceratite microbiana não associada à lente de contato. Acanthamoeba spp. e Pseudomonas spp. amostras positivas foram significativamente correlacionadas com ceratite microbiana associada à lente de contato. Conclusões: A maior prevalência de ceratite microbiana associada à lente de contato no nosso estudo foi observada em mulheres e adultos jovens com idade entre 19 e 40 anos. Staphylococcus spp. e Fusarium spp. foram as bactérias e fungos predominantes isolados nas amostras da córnea. Pseudomonas spp. e Acanthamoeba spp. foram significativamente correlacionados a ceratite microbiana associada à lente de contato neste estudo.

An. bras. dermatol ; 96(3): 349-351, May-June 2021. graf
Article in English | LILACS | ID: biblio-1285054


Abstract Sporotrichosis is a subcutaneous mycosis that affects humans and animals, with a typically subacute or chronic evolution, caused by Sporothrix spp., a dimorphic fungus. Although the cutaneous form is the most frequent presentation, the ocular involvement has been more frequently diagnosed in endemic areas, affecting mainly children and the elderly. Approximately 80% of affected patients have the lymphocutaneous form, while only 2.3% have conjunctival lesions, with 0.7% showing primary ocular involvement. We describe two cases of sporotrichosis with ocular involvement in children through inoculation by felines, with a good response to antifungal treatment.

Humans , Animals , Child , Aged , Cats , Sporotrichosis/diagnosis , Sporotrichosis/drug therapy , Sporothrix , Dermatomycoses/drug therapy , Eye , Antifungal Agents/therapeutic use
Article in Chinese | WPRIM | ID: wpr-912420


Objective:To observe the clinical characteristics of patients with visual impairment caused by fungal sphenoid sinusitis and analyze the influencing factors related to visual prognosis.Methods:A retrospective clinical study. From January 2006 to December 2020, 44 patients (55 eyes) with visual impairment caused by fungal sphenoid sinusitis confirmed by imaging and pathological examination in the Department of Ophthalmology of Beijing Tongren Hospital were included in the study. Patients was first diagnosed in the Department of Ophthalmology due to monocular or binocular vision loss, or binocular diplopia, limited eye movement and ptosis. All patients underwent visual acuity examination and fundus color photography. CT examination of paranasal sinus or orbit was performed in 37 cases; magnetic resonance imaging (MRI) of paranasal sinus, brain or orbit was performed in 34 cases. All patients underwent endoscopic sinus opening combined with intrasinus lesion clearance; 14 cases were treated with antifungal drugs after operation. The average follow-up time was 59.61±37.70 months. Comparison of clinical characteristics between invasive and non-invasive fungal sphenoid sinusitis were by χ 2 test or Fisher exact test. The influencing factors with P<0.2 in univariate analysis were selected for multivariate regression analysis. Results:Among the 44 patients, there were 19 males and 25 females; the ratio of male to female was 1:1.3; the average age of visual symptoms was 61.48 ± 12.17 years; 23 cases (52.3%, 23/44) suffered from immune dysfunction, including 21 cases of diabetes mellitus. The visual acuity decreased in 33 cases (44 eyes) (75.0%, 33/44). There were 15 cases of binocular diplopia with eye movement disorder (34.0%, 15/44), including 6 cases with visual impairment. The visual acuity of the affected eye was no light perception-0.8. There were 35 cases with headache (79.5%, 35/44). Nasal symptoms were found in 14 cases (31.8%, 14/44). There were 40 and 4 cases of Aspergillus and Mucor infection in sphenoid sinus, respectively. Among the 37 cases who underwent CT examination of paranasal sinus or orbit, there were soft tissue filling in the sinus cavity, including 19 cases of high-density calcification in the sinus cavity (51.4%, 19/37); bone defect of sinus wall were in 24 cases (64.9%, 24/37). There were 26 cases (70.3%, 26/37) of sinus wall osteosclerosis. MRI of paranasal sinus, brain or orbit was performed in 34 cases. T1WI of sphenoid sinus lesions showed low signal, high signal and equal signal in 14, 10 and 9 cases, respectively; T2WI showed high signal, low signal and equal signal in 13, 16 and 2 cases respectively. After enhancement, the lesions were strengthened in 11 cases, no obvious enhancement in 23 cases, and the surrounding mucosa was thickened and strengthened. The lesions involved the orbital apex and cavernous sinus in 18 and 16 cases, respectively; orbital apex and cavernous sinus were involved in 12 cases. Six months after operation, visual acuity was significantly improved in 27 eyes (65.9%, 27/41); visual acuity did not improve in 14 eyes (34.1%, 14/41). Multivariate regression analysis showed that the change of sinus wall osteosclerosis was associated with higher visual acuity improvement rate (odds ratio= 0.089, 95% confidence interval 0.015-0.529, P=0.008). Conclusions:Fungal sphenoid sinusitis related visual impairment is relatively common in elderly female patients with low immune function; monocular vision loss with persistent headache is the most common clinical symptom; imaging findings of sphenoid sinus lesions are an important basis for diagnosis. Sphenoid sinus opening combined with sinus lesion clearance is an effective treatment. After operation, the visual acuity of most patients can be improved. The prognosis of visual acuity was relatively good in patients with hyperplasia and sclerosis of sphenoid sinus wall bone.

Article in English | LILACS, VETINDEX | ID: biblio-1344689


Buffaloes are one of the important farm animals in the south of Iraq and play an essential economical role mainly acting as dairy, meat, and draft animals. This study intended to diagnose buffalo mycotic eye infections in Thi-Qar province/Iraq. Some 250 buffaloes in the herd of 3,700 animals suffered from eye infections from December 2017 to November 2018. Eye swabs were collected from each infected eye of the affected buffaloes of both sexes before treatment. The animals were in different age groups. All samples were transferred to the laboratory in transfer media, and cultured on Sabouraud dextrose (SDA) agar with and without 0.05 g/mL and 0.4 g/mL chloramphenicol and cycloheximide, respectively. Later, the agars were incubated at 25oC and 37oC. The total percentage of eye infection was (6.75%), constituting (49.2%) mycotic infections. The predominant clinical manifestations that appeared on the infected buffaloes were eye inflammation represented by congestion, lacrimation, the opacity of cornea and edema, and reduced productivity of the infected animals. Different fungal isolates were identified from the samples including Aspergillus fumigates, Aspergillus flavus, Aspergillus niger, Penicillium spp., Alternaria spp., Fusarium spp., Candida spp., Cladosporium spp., Rhodotorula spp., Mucor spp. and Rhizopus spp. Calves buffaloes below one-year-old were more prone to mycotic infection than one-year-old or more. Additionally, male buffaloes were more susceptible to infection than females. In conclusion, this study isolated various types of fungus from the inflamed eyes of buffaloes. Fungal eye infection and the potential risk factors for fungal keratitis in buffaloes were also investigated. The study also approved the rapid diagnosis of fungi by direct microscopic detection and culture. The author recommends future studies including large numbers of the buffalo herd in Iraq to determine the epidemiology of this condition in the country.(AU)

Os búfalos são um dos animais de fazenda mais importantes no sul do Iraque e desempenham um papel econômico essencial, atuando principalmente na produção de leite, carne e como animal de tração. Este estudo objetivou diagnosticar infecções oculares micóticas em búfalos na província de Thi-Qar, Iraque. 250 búfalos no rebanho de um total de 3700 animais apresentaram infecção ocular durante o período compreendido entre dezembro de 2017 e novembro de 2018. Os esfregaços oculares foram colhidos dos olhos infectados dos búfalos afetados de ambos os sexos antes do tratamento. Os animais estavam em diferentes faixas etárias. Todas as amostras foram transferidas para o laboratório por meio de transferência e cultivadas em Ágar Sabouraud e Dextrose (SDA) com e sem 0,05 g/mL e 0,4 g/mL de cloranfenicol e cicloheximida, respectivamente. Posteriormente, os ágares foram incubados a 25ºC e 37ºC. A porcentagem total de infecção ocular foi de 6,75%, representando 49,2% de infecção micótica. As manifestações clínicas predominantes nos búfalos infectados foram inflamação ocular com congestão, lacrimejamento, opacidade da córnea e edema. Os animais acometidos também apresentaram redução de produtividade. Diferentes isolados de fungos foram identificados a partir das amostras, incluindo Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Penicillium spp., Alternaria spp., Fusarium spp., Candida spp., Cladosporium spp., Rhodotorula spp., Mucour spp. e Rizopus spp. Búfalos com menos de um ano de idade foram mais propensos a infecções micóticas do que com um ano ou mais. Além disso, os búfalos machos foram mais suscetíveis a infecção do que as fêmeas. Em conclusão, este estudo registrou o isolamento de vários tipos de fungos em olhos inflamados de búfalos. Além disso, a infecção ocular por fungos e os fatores de risco potenciais para ceratite fúngica em búfalos também foram observados. O estudo também aprovou o diagnóstico rápido de fungos por detecção microscópica direta e cultura. O autor recomenda outro estudo futuro, incluindo um grande número de rebanhos de búfalos no Iraque para determinar a epidemiologia desta condição no país.(AU)

Animals , Aspergillus flavus , Buffaloes/anatomy & histology , Eye Infections, Fungal
Arq. bras. oftalmol ; 83(6): 463-472, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1153079


ABSTRACT Purpose: The aims of this study were to characterize alpha-hemolytic streptococci among isolates from cases of infectious endophthalmitis and keratitis and to determine their distributions. Methods: The sample included 27 and 35 nonduplicated isolates of alpha-hemolytic streptococci recovered from patients with infectious endophthalmitis (2002-2013) and keratitis (2008-2013), respectively. Isolates were identified by the optochin susceptibility and bile solubility tests, using a biochemical identification system. The minimum inhibitory concentration was determined by the broth microdilution method. Molecular identification was performed by analyses of three constitutive genes and the complementary multilocus sequence. The molecular epidemiology of Streptococcus pneumoniae was investigated using multilocus sequence typing, and the presence of the capsular polysaccharide-encoding gene was assessed using conventional polymerase chain reaction. Outcomes were evaluated using the patients' medical records. Results: Phenotypic tests differentiated S. pneumoniae from other alpha-hemolytic streptococci, consistent with later molecular identifications. Streptococcus oralis was significantly prevalent among the endophthalmitis isolates, as was S. pneumoniae in the keratitis isolates. High levels of susceptibility to antibiotics were observed, including vancomycin, cephalosporins, and fluoroquinolones. High genetic variability was detected among the 19 S. pneumoniae strains, with 15 predicted to be encapsulated. The medical records of patients with infectious endophthalmitis were reviewed (n=15/27; 56%), and final visual acuity was assessed in 12 cases (44%). Many patients progressed to a final visual acuity state of "no light perception" (6/12; 50%), "light perception" (3/12; 25%), or "hand motion" (1/12; 8%). The medical records of patients with infectious keratitis were also reviewed (n=24/35; 69%), and final visual acuity was assessed in 18 cases (51%). Similarly, most patients progressed to a final visual acuity state of "no light perception" (6/18; 33%), "light perception" (1/18; 6%), or "hand motion" (6/18; 33%). Overall, the majority of patients progressed to a final visual acuity state of "no light perception" (12/30), "light perception" (4/30), or "hand motion" (7/30). Conclusions: The distribution of alpha-hemolytic streptococci in ocular infections suggested the presence of a species-specific tissue tropism. The prognoses of patients with ocular streptococcal infections were highly unfavorable, and antibiotic resistance did not contribute to the unfavorable clinical progressions and poor outcomes.

RESUMO Objetivo: O objetivo deste estudo foi caracterizar os estreptococos alfa-hemolíticos isolados de endoftalmite infecciosa e ceratite e determinar sua distribuição. Métodos: A amostra incluiu 27 e 35 isolados não-duplicados de estreptococos alfa-hemolíticos recuperados de pacientes com endoftalmite infecciosa (2002-2013) e ceratite (2008-2013), respectivamente. Os isolados foram identificados pelos testes de suscetibilidade à optoquina e bile solubilidade, utilizando um sistema de identificação bioquímica. A concentração inibitória mínima foi determinada pelo método de microdiluição em caldo. A identificação molecular foi realizada pela análise de três genes constitutivos e análise complementar de sequências multilocus. A epidemiologia molecular do Streptococcus pneumoniae foi investigada por tipagem de sequência multilocus, e a presença do gene codificador do polissacarídeo capsular foi avaliada por reação em cadeia da polymerase convencional. Os resultados foram avaliados utilizando os prontuários médicos dos pacientes. Resultados: Os testes fenotípicos diferenciaram S. pneumoniae dos outros estreptococos alpha-hemolíticos, consistentes com identificações moleculares posteriores. S. oralis foi significativamente prevalente entre os isolados de endoftalmite, assim como S. pneumoniae nos isolados de ceratite. Foram observados altos níveis de suscetibilidade a antibióticos, incluindo vancomicina, cefalosporinas e fluoroquinolonas. Alta variabilidade genética foi detectada entre as 19 cepas de S. pneumoniae, com 15 previstas para serem encapsuladas. Os prontuários médicos dos pacientes com endoftalmite infecciosa foram revisados (n=15/27; 56%), e a acuidade visual final foi avaliada em 12 casos (44%). Muitos pacientes evoluiram para um estado final de acuidade visual de "sem percepção luminosa" (6/12; 50%), "percepção luminosa" (3/12; 25%) ou "movimentos de mãos" (1/12; 8%). Também foram revisados os prontuários médicos dos pacientes com ceratite infecciosa (n=24/35; 69%), e a acuidade visual final foi avaliada em 18 casos (51%). Da mesma foram, a maioria dos pacientes evoluiu para um estado final de acuidade visual de "sem percepção luminosa" (6/18; 33%), "percepção luminosa" (1/18; 6%) ou "movimentos de mãos" (6/18; 33%). No geral, a maioria dos pacientes evoluiu para um estado final de acuidade visual de "sem percepção luminosa" (12/30), "percepção luminosa" (4/30) ou "movimentos de mãos" (7/30). Conclusões: A distribuição de estreptococos alfa-hemolíticos nas infecções oculares sugeriu a presença de um tropismo de tecido específico da espécie. Os prognósticos dos pacientes com infeções oculares por estreptococos foram altamente desfavoráveis e a resistência a antibióticos contribuiu não para as progressões clínicas des­favoráveis e os maus resultados.

Humans , Endophthalmitis , Endophthalmitis/drug therapy , Endophthalmitis/epidemiology , Keratitis , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology , Streptococcus pneumoniae , Microbial Sensitivity Tests , Keratitis/drug therapy , Keratitis/epidemiology
Rev. bras. oftalmol ; 79(5): 333-335, set.-out. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137995


Abstract This report presents a rare case of endogenous endophthalmitis due to Kingella kingae infectious endocarditis. Endogenous endophthalmitis is a rare condition that has a systemic underlying cause, with hematogenic dissemination of a pathogen that will eventually reach and infect the eye. In this article, we present a case of a 54-year-old woman with fever, chills and decreased visual acuity and pain in the right eye. The slit-lamp exam showed conjunctival injection, anterior chamber reaction with a great amount of fibrinous material obscuring her visual axis. Ultrasound echography revealed profuse exudates and scarce membranous formation in the posterior segment. Blood culture was positive for Kingella kingae, and the patient was treated with intravenous ceftriaxone, along with topic dexamethasone and mydriatic. After 15 days of intravenous antibiotic therapy, the patient exhibited best visual acuity of 20/60. Endogenous endophthalmitis is an ocular emergency that demands quick diagnosis and aggressive intervention in order to preserve vision. Therefore, it is important to recognize its signs and symptoms with no retard.

Resumo O presente relato apresenta um raro caso de endoftalmite endógena por endocardite devido à Kingella kingae. Endoftalmite endógena é uma doença pouco comum com uma causa sistêmica subjacente. A disseminação hematogênica de um microrganismo infeccioso leva à infecção ocular. Nesse artigo, apresentamos o caso de uma mulher com 54 anos, febre, calafrios, baixa da acuidade visual e dor em olho direito. Ao exame na lâmpada de fenda apresentava injeção conjuntival, reação de câmara anterior e acúmulo de fibrina no eixo visual. Ultrassonografia revelou exsudatos profusos e escassa formação membranosa em segmento posterior.A hemocultura foi positiva para Kingella kingae e a paciente foi tratada com ceftriaxone venoso conjuntamente com dexametasona e midriático tópicos. Após 15 dias de terapia antibiótica endovenosa, a paciente apresentou acuidade visual corrigida de 20/60. Endoftalmite endógena é uma emergência ocular que demanda rápido diagnóstico e intervenção agressiva para preservar a visão. Portanto, é importante o reconhecimento precoce dos sinais e sintomas.

Humans , Female , Middle Aged , Ceftriaxone/therapeutic use , Eye Infections, Bacterial/drug therapy , Endophthalmitis/drug therapy , Endophthalmitis/epidemiology , Kingella kingae , Endocarditis, Bacterial/complications , Injections, Intravenous
Rev. bras. oftalmol ; 79(5): 315-319, set.-out. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137981


Abstract Purpose: To report etiological diagnosis, predisposing risk factors, therapeutic strategies and visual outcome of patients treated at the Department of Ophthalmology of Federal University of São Paulo. Methods: This is a retrospective, descriptive, and observational study from medical and laboratory records of the Department of Ophthalmology of Federal University of São Paulo, including all patients with culture proven fungal keratitis in 5 years, from October 2012 through October 2017. Results: There were 2260 fungi microbiologic test requests. Of these, 140 samples had positive cultures for fungi and sixty-six patients were followed at our clinic. Forty-five patients (68.2%) were men, and the mean age was 48.06 (±17.39) years. Fusarium spp. was the most frequently isolated fungus (32 cases; 48.5%), followed by Candida parapsilosis (12 cases; 18.2%). Thirty-four patients (51.5%) underwent intracameral injection of amphotericin B (5 µg per 0.1 ml). In 11 patients (32.3%), infection was eradicated after intracameral amphotericin B associated to topical antifungal treatment and, in 23 patients (67.7%), therapeutic keratoplasty was needed. No complication related to intracameral amphotericin B injection was observed in this series. Forty-three patients (65.1%) ended up with therapeutic keratoplasty. Three patients (4.5%) evolved to evisceration or enucleation. At the last follow-up visit, 53 patients (80.3%) had visual acuity worse than 20/200. Conclusion: Despite current antifungals drugs and distinct administration strategies, fungal keratitis remains challenging. Delayed antifungal therapy may explain poor clinical outcomes. Intracameral amphotericin B associated to topical antfungal treatment seems to be a safe and helpful alternative for non-responsive fungal keratitis. But it is important to formulate other treatment strategies, hence to improve patients' outcomes, since most patients ended-up with significant visual impairment even after current treatment.

Resumo Objetivo: Descrever diagnósticos etiológicos, fatores de risco, estratégias terapêuticas e resultados visuais de pacientes com ceratite fúngica tratados no Departamento de Oftalmologia da Universidade Federal de São Paulo. Métodos: Trata-se de um estudo retrospectivo, descritivo e observacional, a partir da análise de prontuários médicos e laboratoriais do Departamento de Oftalmologia da Universidade Federal de São Paulo, incluindo todos os pacientes com ceratite fúngica comprovada por cultura no período de outubro de 2012 a outubro de 2017. Resultados: Foram realizadas 2260 solicitações de testes microbiológicos. Destas, 140 amostras apresentaram culturas positivas para fungos, e 66 pacientes foram acompanhados em nosso serviço. Quarenta e cinco pacientes (68,2%) eram do sexo masculino, e a média de idade foi de 48,06 (± 17,39) anos. Fusarium spp. foi o fungo mais freqüentemente isolado (32 casos; 48,5%), seguido por Candida parapsilosis (12 casos; 18,2%). Trinta e quatro pacientes (51,5%) foram submetidos à injeção intracameral de anfotericina B (5 µg por 0,1 ml). Destes, 11 pacientes (32,3%) tiveram a infecção erradicada. Nos outros 23 pacientes (67,7%), o transplante terapêutico foi necessário. Nenhuma complicação relacionada à injeção intracameral de anfotericina B foi observada neste estudo. No total, 43 pacientes (65,1%) evoluíram para transplante terapêutico, e 3 pacientes (4,5%) foram submetidos à evisceração ou enucleação. Cinquenta e três pacientes (80,3%) apresentaram acuidade visual final pior que 20/200. Conclusões: Apesar dos diversos medicamentos antifúngicos atuais e vias de administração, o tratamento das ceratites fúngicas permanece desafiador. O atraso no início do tratamento adequado pode justificar o desfecho clínico desfavorável de grande parte dos pacientes. A injeção intracameral de anfotericina B mostrou-se uma alternativa terapêutica segura para ceratites fúngicas refratárias. Mas outras estratégias de tratamento devem ser formuladas, visando melhorar os resultados visuais dos pacientes.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Eye Infections, Fungal/drug therapy , Amphotericin B/therapeutic use , Corneal Transplantation , Candida parapsilosis/isolation & purification , Fusarium/isolation & purification , Keratitis/microbiology , Antifungal Agents/therapeutic use , Brazil , Medical Records , Epidemiology, Descriptive , Retrospective Studies , Observational Study
Rev. bras. oftalmol ; 79(4): 266-269, July-Aug. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1137972


Resumo É apresentado o caso de uma paciente do sexo feminino, 77 anos, internada por pielonefrite e tratada com antibóticos de amplo espectro, tendo desenvolvido endoftalmite endógena bilateral presumida por Candida. Foi submetida à vitrectomia via pars plana e injeção intravítrea de anfotericina B, além de voriconazol oral. São abordados, ainda, os aspectos clínicos da endoftalmite endógena por meio de revisão da literatura.

Abstract A 77 year-old female patient suffering from pyelonephritis developed bilateral endogenous endophthalmitis presumed by Candida after have been treated with global spectrum antibiotics. Early vitrectomy and intravitreal amphotericin B injection were performed, in addition to oral voriconazole. Clinical aspects of endogenous endophthalmitis are also pointed out by a literature review.

Humans , Male , Female , Aged , Vitrectomy , Candida albicans , Eye Infections, Fungal/drug therapy , Amphotericin B/therapeutic use , Endophthalmitis/surgery , Endophthalmitis/drug therapy , Intravitreal Injections , Voriconazole/therapeutic use , Antifungal Agents/therapeutic use
An. Fac. Med. (Perú) ; 81(2): 224-229, abr-jun 2020. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1278270


RESUMEN El COVID-19 ocasiona manifestaciones clínicas diversas, las manifestaciones oftalmológicas se presentan como conjuntivitis virales. Luego del ingreso del virus, se producen complejas rutas de respuesta inmunológica. Se hallan receptores para el virus en células de la superficie ocular, con predisposición a infección local. Es probable que luego del ingreso del virus se presente una respuesta limitada de la inflamación ocular, el cual podría estar mediado por el enfoque de privilegio inmune.

ABSTRACT COVID-19 causes various clinical manifestations, ophthalmological manifestations present as viral conjunctivitis. After the entry of the virus, it will produce complex immune response routes, receptors for the virus are found in cells of the ocular surface, therefore it could give a local infection, it is likely that after the entry of the virus, a limited response of ocular inflammation, which could be mediated by the immune privilege approach.

Arq. bras. oftalmol ; 83(1): 65-68, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088960


ABSTRACT We describe a case of keratomycosis caused by Arthographis kalrae after excimer laser keratomileusis. A 38-year-old female developed stromal keratitis eight weeks after refractive surgery. She developed severe corneal stromal infiltration and mild anterior segment inflammation, which could not be treated with topical voriconazole 1%, but topical natamycin 5% ameliorated her condition. A reactivation of keratomycosis symptoms was observed; therefore, longer treatment was administered to the patient. It has been reported that A. kalrae keratomycosis is associated with exposure to soil and contact lens usage. However, the patient, who lived in a rural location, was neither involved in gardening activities nor had a history of wearing contact lenses. This is the first case of post-refractive A. kalrae keratomycosis.

RESUMO Descrevemos um caso de ceratomicose por Arthographis kalrae após ceratomileusis por excimer laser. Uma mulher de 38 anos desenvolveu ceratite estromal oito semanas após a cirurgia refrativa. Ela desenvolveu infiltração estromal grave da córnea e uma leve inflamação do segmento anterior, que não pode ser tratada com voriconazol tópico a 1%, mas a natamicina tópica a 5% melhorou sua condição. Uma reativação dos síntomas de ceratomicose foi observada; portanto, tratamento mais prolongado foi administrado a paciente. Tem sido relatado que a ceratomicose por A. kalrae está associada à exposição ao solo e ao uso de lentes de contato. No entanto, a paciente, que vivía em um local rural, não estava envolvida em atividades de jardinagem e nem tinha histórico de uso de lentes de contato. Este é o primeiro caso de ceratomicose pós-refrativa por A. kalrae.

Humans , Female , Adult , Eye Infections, Fungal/microbiology , Keratitis/microbiology , Ascomycota/isolation & purification , Eye Infections, Fungal/drug therapy , Natamycin/therapeutic use , Keratomileusis, Laser In Situ/adverse effects , Voriconazole/therapeutic use , Keratitis/drug therapy
Rev. bras. oftalmol ; 78(6): 370-374, nov.-dez. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1057909


Resumo Objetivo: A queratite infeciosa é uma doença de incidência relativamente elevada e é responsável por um número importante de internamentos. Neste estudo pretende-se estudar diversas características epidemiológicas e clínicas associadas às queratites infeciosas de alto risco num hospital terciário em Portugal. Métodos: Realizou-se um estudo retrospetivo, onde foram incluídos todos os doentes internados por abcesso da córnea no Centro Hospitalar Universitário do Porto (CHUP), entre Abril de 2013 a Março de 2018. Caracterizou-se a população em relação aos fatores de risco, apresentação clínica, tempo de internamento, resultados de culturas, resistência antibiótica in vitro, tratamento efetuado e resultado funcional. Resultados: O estudo incluiu 105 doentes. Os principais fatores de risco foram antecedentes de cirurgia de córnea, uso de lentes de contacto e história recente de trauma ocular. 74,3% dos doentes tiveram cultura positiva com 87,9% a corresponderem a cultura bacteriana pura, sendo a Pseudomonas aeruginosa e o Streptococcus pneumoniae os agentes etiológicos mais frequentes. 27,9% das culturas positivas eram resistentes a 3 ou mais classes de antibióticos. Todos os doentes iniciaram tratamento com colírios fortificados. 29,5% dos doentes necessitaram de realizar transplante de córnea. Ao final de 6 meses de seguimento, apenas 20,9% apresentavam AV>20/40. Conclusão: Na maioria dos casos, a etiologia foi bacteriana. Observou-se um número considerável de bactérias multirresistentes. Apesar do tratamento ter permitido uma melhoria da visão na maioria dos casos, um número considerável de doentes ficou com sequelas visuais importantes.

Abstract Objective: Infectious keratitis is a pathology with a high incidence and is responsible for a large number of prolonged stay hospital admissions. The purpose was to analyze the epidemiological and clinical data associated with high risk microbial keratitis at a central hospital in Portugal. Methods: A retrospective study of all inpatients presenting with corneal abscess in Centro Hospitalar Universitário do Porto, from April 2013 to March 2018 was performed. Target population was characterized by risk factors, clinical features, length of stay, culture results, in vitro antibiotic resistance, treatment and outcome. Results: This study included 105 patients. The main risk factors were previous corneal surgery, contact lenses wear and recent history of ocular trauma. 74.3% of patients had a positive culture, 87.9% of these corresponding to a pure bacterial culture, with Pseudomonas aeruginosa and Streptococcus pneumoniae being the most common pathogens. 27.9% of positive cultures were resistant to 3 or more classes of antibiotics. All patients began treatment with fortified drops. 29.5% of patients required a corneal transplant. After 6 months of follow-up, only 20.9% presented a VA>20/40. Conclusion: Most cases were caused by bacteria. A considerable number of multi-resistant bacteria was identified. Despite most cases having improved after treatment, a large number of patients had a significant visual acuity sequelae.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Eye Infections, Bacterial/epidemiology , Eye Infections, Fungal/epidemiology , Eye Infections, Parasitic/epidemiology , Eye Infections, Viral/epidemiology , Keratitis/epidemiology , Ophthalmic Solutions , Portugal , Bacteria/isolation & purification , Viruses/isolation & purification , Drug Resistance, Microbial , Acanthamoeba/isolation & purification , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/therapy , Eye Infections, Fungal/microbiology , Eye Infections, Fungal/therapy , Eye Infections, Parasitic/microbiology , Eye Infections, Parasitic/therapy , Eye Infections, Viral/microbiology , Eye Infections, Viral/drug therapy , Retrospective Studies , Risk Factors , Corneal Transplantation , Fungi/isolation & purification , Hospitals, University/statistics & numerical data , Inpatients , Keratitis/microbiology , Keratitis/therapy
Rev. bras. oftalmol ; 78(5): 338-341, Sept.-Oct. 2019.
Article in Portuguese | LILACS | ID: biblio-1042383


Resumo A febre Chikungunya é um problema de saúde pública mundial, com potencial para gerar epidemias de alta morbidade, visto que elevado número de pacientes pode apresentar sequelas articulares prolongadas e alterações oftalmológicas. As manifestações oftalmológicas podem estar presentes na fase aguda da doença ou ter início após várias semanas da instalação do quadro. Na literatura mundial é descrito desde alterações mais comuns e de fácil tratamento como conjuntivites até alterações mais complexas e que podem cursar com sequelas visuais graves como a retinite e neurite óptica.

Abstract Chikungunya fever is a world public health problem with the potential to generate epidemics of high morbidity, since a high number of patients may present prolonged joint sequelae and ophthalmological alterations. Ophthalmologic manifestations may be present in the acute phase of the disease or begin after several weeks of the onset of the disease. In the world literature is described from more common and easy to treat changes such as conjunctivitis to more complex changes and that can occur with severe visual sequelae such as retinitis and optic neuritis.

Humans , Eye Diseases/etiology , Chikungunya Fever/complications , Antiviral Agents/therapeutic use , Serologic Tests/methods , Chikungunya virus/isolation & purification , Chikungunya virus/immunology , Chloroquine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Eye Diseases/diagnosis , Eye Diseases/drug therapy , Chikungunya Fever/diagnosis , Chikungunya Fever/drug therapy , Chikungunya Fever/blood , Chikungunya Fever/epidemiology , Anti-Inflammatory Agents/therapeutic use
Arq. bras. oftalmol ; 82(2): 152-154, Mar.-Apr. 2019. graf
Article in English | LILACS | ID: biblio-989405


ABSTRACT - We describe here a case of a 21-year-old woman who presented with low visual acuity, pain, and hyperemia in the left eye for 45 days. Her eye had extensive corneal infiltrate, with melting and a central perforation that was glued with cyanoacrylate, but with Seidel (+). She underwent tectonic corneal transplantation, and anterior chamber lavage with subconjunctival infiltration with voriconazole, as well as intracameral injections of amphotericin B. Laboratory tests revealed Paecilomyces lilacinus as the infectious agent. The patient was then maintained with oral voriconazole and eye drops for three months, after which the infection was considered cured. However, in the sixth postoperative month she presented with endothelial rejection, and two weeks later signs of recurrence of the fungal infection. She was treated with two further washes of the anterior chamber and subconjunctival injection of voriconazole, followed by intravenous voriconazole that was replaced with drops after ten days. The infection initially worsened, but then regressed, and at last follow-up, the patient was still infection-free.

RESUMO - Descrevemos aqui um caso de uma mulher de 21 anos que apresentou baixa acuidade visual, dor e hiperemia no olho esquerdo por 45 dias. O olho apresentava infiltrado corneano extenso, com fusão e perfuração central colada com cianoacrilato, mas com Seidel (+). Ela foi submetida a transplante de córnea tectônica e lavagem de câmara anterior com infiltração subconjuntival com voriconazol, além de injeções intracamerais de anfoterecina B. Testes laboratoriais revelaram Paecilomyces lilacinus como agente infeccioso. A paciente foi então mantida com voriconazol oral e colírio por período de três meses, após o qual a infecção foi considerada curada. No entanto, no sexto mês de pós-operatório, ela apresentou rejeição endotelial e, duas semanas após, sinais de recidiva de infecção fúngica. Ela foi tratada com mais duas lavagens de câmara anterior e injeção subconjuntival de voriconazol, seguida por voriconazol intravenoso que foi substituído por gotas após 10 dias. A infecção piorou inicialmente, mas depois regrediu e, no último seguimento, o paciente ainda estava livre de infecção.

Humans , Female , Young Adult , Paecilomyces/isolation & purification , Eye Infections, Fungal/drug therapy , Voriconazole/therapeutic use , Keratitis/microbiology , Keratitis/drug therapy , Antifungal Agents/therapeutic use , Eye Infections, Fungal/surgery , Corneal Transplantation/methods , Treatment Outcome , Injections, Intraocular , Keratitis/surgery
Rev. bras. oftalmol ; 78(1): 49-51, jan.-fev. 2019. graf
Article in Portuguese | LILACS | ID: biblio-990793


Resumo O presente relato apresenta o caso de conjuntivite causada por Ralstonia pichettii em paciente imunocompetente usuária de lente de contato. A bactéria isolada da solução utilizada para desinfecção das lentes R. pichettii não pertente a microbiota humana mas infecta pacientes imunodeprimidos e está presente em soluções aquosas. Não há padronização de sensibilidade para esta bactéria e poucos antibióticos foram testados para bactérias não fermentadoras da glicose. Devido ao reduzido perfil de sensibilidade aos antimicrobianos demonstrado pela R. pichettii, torna-se importante a identificação correta deste agente etiológico em quadros de conjuntivite e ceratites. Este relato de caso ilustra que R. Pickettii é um patógeno mais importante do que se pensava anteriormente.

Abstract The present report reports a case of conjunctivitis caused by Ralstonia pichettii in an immunocompetent patient wearing a contact lens. The bacterium isolated from the solution used to disinfect R. pichettii does not belong to the human microbiota but infects immunodepressed patients and is present in aqueous solutions. There is no standardization of sensitivity for this bacterium and few antibiotics have been tested for non-fermenting glucose bacteria. Due to the reduced antimicrobial sensitivity profile demonstrated by R. pichettii, it is important to correctly identify this etiologic agent in conjunctivitis and keratitis. This case report illustrates that R. Pickettii is a more important pathogen than previously thought.

Humans , Female , Middle Aged , Conjunctivitis, Bacterial/etiology , Gram-Negative Bacterial Infections , Contact Lenses/adverse effects , Ralstonia pickettii
Arq. bras. oftalmol ; 82(1): 2-5, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-973875


ABSTRACT Purpose: To determine whether a correlation exists between pathogenic species and clinical findings, disease severity, and visual outcome in patients with keratitis and fungal growth in microbiological culture. Methods: A retrospective study of patients with fungal growth in the microbiological culture of corneal scrapings. Patients were treated at an ophthalmologic reference center in Southeastern Brazil from January 1992 to October 2015. Results: Medical records of 181 patients (131 males and 50 females) with a mean age of 47 ± 18 years were analyzed. The three most common etiologies were Fusarium sp. (38.7%), Aspergillus sp. (15%), and Candida sp. (13.2%). Among these, Fusarium sp. was the most frequent in patients aged £50 years (p=0.002) and in those with a recent history of a foreign body and/or ocular trauma (p=0.01). Candida sp. was the most frequent etiology in patients aged >50 years (p=0.002), in those with postoperative ocular surgery (p=0.002); in those with a previous ocular pathology (p=0.0007); and in immunodepressed patients (p=0.0004). Conclusion: Fusarium sp. was predominant in patients aged £50 years and those with a recent history of foreign body and/or ocular trauma, whereas Candida sp. was predominant in older adults, in those with a postoperative ocular surgery, in those with a previous ocular pathology, and in immunodepressed patients.

RESUMO Objetivo: Determinar se existe uma correlação entre espécies patogênicas e achados clínicos, gravidade da doença e resultado visual em pacientes com ceratite e crescimento de fungos em cultura microbiológica. Métodos: Estudo retrospectivo de pacientes com crescimento de fungos na cultura microbiológica de raspado de córnea. Os pacientes foram tratados em um centro de referência oftalmológica no Sudeste do Brasil de janeiro de 1992 a outubro de 2015. Resultados: Foram analisados registros médicos de 181 pacientes (131 homens e 50 mulheres) com idade média de 47 ± 18 anos. As três etiologias mais comuns foram Fusarium sp. (38,7%), Aspergillus sp. (15%) e Candida sp. (13,2%). Entre estas, Fusarium sp. foi a mais frequente em pacientes com idade £50 anos (p=0,002) e naqueles com história recente de corpo estranho e/ou trauma ocular (p=0,01). Candida sp. foi a etiologia mais frequente em pacientes com idade >50 anos (p=0,002), naqueles com cirurgia ocular pós-operatória (p=0,002); naqueles com patologia ocular prévia (p=0,0007); e em pacientes imunodeprimidos (p=0,0004). Conclusão: Fusarium sp. foi predominante em pacientes com idade £50 anos e naqueles com história recente de corpo estranho e/ou trauma ocular; enquanto Candida sp. foi predominante em adultos mais velhos, naqueles com cirurgia ocular pós-operatória, naqueles com patologia ocular prévia e em pacientes imunodeprimidos.

Humans , Male , Female , Adult , Middle Aged , Aged , Eye Infections, Fungal/microbiology , Eye Infections, Fungal/pathology , Corneal Ulcer/microbiology , Corneal Ulcer/pathology , Aspergillus/pathogenicity , Severity of Illness Index , Candida/pathogenicity , Visual Acuity , Eye Infections, Fungal/drug therapy , Corneal Ulcer/drug therapy , Eye Foreign Bodies/microbiology , Eye Foreign Bodies/pathology , Retrospective Studies , Risk Factors , Corneal Injuries/microbiology , Corneal Injuries/pathology , Fusarium/pathogenicity , Antifungal Agents/therapeutic use
Rev. Soc. Colomb. Oftalmol ; 52(1): 48-52, 2019. ilus.
Article in Spanish | LILACS, COLNAL | ID: biblio-1026474


Introducción: La úlcera corneal de etiología micótica por Lasiodiplodia theobromae es una patología infrecuente con menos de 50 casos de infección ocular por este patógeno reportados en la literatura. Objetivo: Dar a conocer un caso de una patología poco frecuente, haciendo una breve revisión de la literatura, y discutiendo el tratamiento elegido que resultó favorable. Diseño del estudio: Reporte de caso. Resumen del caso: Se presenta el caso de un paciente atendido en el Hospital Universitario de Santander (HUS) durante los años 2015 - 2017 con antecedente de trauma ocular con material vegetal quien desarrolla úlcera corneal micótica por Lasiodiplodia theobromae, que se confi rmó usando análisis microbiológico del frotis corneal. Se instauró tratamiento con una combinación de antimicóticos con un resultado final satisfactorio. Conclusión: L. theobromae es un patógeno oportunista. La importancia del diagnóstico precoz en estos casos, que requiere un alto índice de sospecha en pacientes con trauma vegetal, con la identificación del agente etiológico radica en evitar o minimizar consecuencias irreversibles mediante la instauración de un tratamiento oportuno.

Background: The corneal ulcer of mycotic etiology caused by Lasiodiplodia theobromae is an infrequent pathology with less than 50 cases of ocular infection by this pathogen reported in the literature. Objective: To present a case of a rare pathology, make a brief literature review, and discuss the chosen treatment that was favorable. Study design: Case report. Case summary: We present the case of a patient treated at the Hospital Universitario de Santander (HUS) during the years 2015 - 2017 with a history of ocular trauma with plant material who developed fungal corneal ulcer by Lasiodiplodia theobromae, which was confi rmed using microbiological analysis of the corneal smear. Treatment with a combination of antifungals was established with a satisfactory final result. Conclusion: L. theobromae is an opportunistic pathogen. The importance of early diagnosis in these cases, which requires a high index of suspicion in patients with plant trauma, with the identifi cation of the etiological agent lies in avoiding or minimizing irreversible consequences through the establishment of an opportune treatment.

Corneal Ulcer/diagnosis , Eye Infections , Eye Infections, Fungal/virology , Corneal Ulcer/therapy
Article in Korean | WPRIM | ID: wpr-766871


PURPOSE: To investigate risk factors, clinical features, pathogenic organisms, and outcomes in patients with infectious scleritis. METHODS: This study was a retrospective review of 20 patients with infectious scleritis who were admitted from January 2011 to December 2018 in a single tertiary hospital, with at least 3 months of follow-up. We analyzed age, risk factors, clinical manifestations, pathogenic organisms, treatment, and outcomes of infectious scleritis. RESULTS: The mean patient age was 69.2 ± 8.4 years and the mean duration of hospitalization was 11.3 ± 5.8 days. Furthermore, the mean duration of symptoms before presentation was 16.8 ± 13.9 days; patients were followed for a mean duration of 23.3 ± 25.4 months. All patients had prior pterygium surgery. Eighteen patients (90%) were culture-positive and Pseudomonas aeruginosa (P. aeruginosa) was identified in 12 eyes. In the acute stages, adjuvant surgical intervention was performed for 18 patients (90%) for these patients, the mean duration of hospitalization before surgery was 4.1 ± 4.4 days. CONCLUSIONS: The most common risk factor and pathogenic organism for infectious scleritis were prior pterygium surgery and P. aeruginosa, respectively. Identification of specific causative organisms and corresponding antibiotic treatment with adjuvant surgical intervention may improve visual prognosis in patients with infectious scleritis.

Eye Infections , Follow-Up Studies , Hospitalization , Humans , Prognosis , Pseudomonas aeruginosa , Pterygium , Retrospective Studies , Risk Factors , Scleritis , Tertiary Care Centers
Article in Korean | WPRIM | ID: wpr-738607


PURPOSE: To report two cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which appeared as hyperacute presentation and panophthalmitis. CASE SUMMARY: A 68-year-old male was treated with cataract surgery and was evaluated the next day (less than 24 hours after surgery) because of acute loss of vision. There was severe inflammation and the visual acuity was light perception. The patient underwent pars plana vitrectomy (PPV) with intravitreal antibiotic injection. The vitreous culture revealed SDSE. After PPV, regression of inflammation was observed, although the corneal edema had progressed. The cornea evolved to decompensate due to bullous keratopathy and visual acuity of the eye decreased to no light perception after 3 months. A 87-year-old male who underwent phacoemulsification and intraocular lens implantation 2 days previously was hospitalized due to severe ocular pain and visual loss. There was severe inflammation, and the visual acuity was no light perception. The patient received only intravitreal injections of antibiotics due to severe corneal necrosis. The aqueous humor revealed SDSE. Four days after intravitreal injection, erythema and swelling of the eyelid of the affected eye was observed, and diagnosed as panophthalmitis. After treatment with intravenous antibiotics, cellulitis of the eyelid was resolved. The eye progressed as phthisis after 3 months without recurrence. CONCLUSIONS: Postoperative SDSE endophthalmitis showed aggressive and hyperacute presentation, resulting in blindness despite prompt treatment. SDSE is an emerging organism and should be considered a potential cause of postoperative endophthalmitis.

Aged , Aged, 80 and over , Anti-Bacterial Agents , Aqueous Humor , Blindness , Cataract , Cellulitis , Cornea , Corneal Edema , Endophthalmitis , Erythema , Eye Infections , Eyelids , Humans , Inflammation , Intravitreal Injections , Lens Implantation, Intraocular , Male , Necrosis , Panophthalmitis , Phacoemulsification , Recurrence , Streptococcus , Visual Acuity , Vitrectomy
Acta méd. peru ; 35(4): 229-232, oct.-dic. 2018. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1010920


La oftalmomiasis es una patología poco descrita en Sudamérica, con presencia en la Amazonía peruana, causado por la larva de distintas moscas. Una de las especies más prevalentes pero poco reportada en nuestra región es Oestrus sp. Se reporta el caso de un adolescente de 14 años, con molestias oculares y presencia de una larva de mosca a nivel subconjuntival diagnosticado como oftalmomiasis externa, el cual se logró extraer mediante métodos médicos y alternativos; así como, control antibiótico y antiparasitario para prevenir las complicaciones. El manejo de las oftalmomiasis es muy variado y empírico, por lo que este tipo de reportes pueden ayudar a los profesionales de la salud que ejercen en la selva peruana, a brindar un diagnóstico oportuno y un tratamiento rápido.

Ophthalmomyiasis is a condition that has rarely been described in South America, it is present in the Peruvian Amazon forest, and it is caused by larvae from different fly species. One of the most prevalent but seldom reported species in this region is Oestrus sp. We report the case of a 14-year-old subject that presented with eye disturbances and the presence of a fly larva in the subconjunctival space, which was diagnosed as external ophthalmomyiasis. The larva was excised using medical and alternative methods, antibiotics and antiparasitic drugs were also used, aiming to prevent complications. There is no standard management protocol for ophthalmomyiasis, so this report may be of help for healthcare professionals working in the Peruvian Amazon forest, aiming to achieve a timely diagnosis and prompt therapy.

Rev. bras. oftalmol ; 77(4): 219-221, jul.-ago. 2018. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-959094


RESUMO O objetivo deste resumo é relatar um caso de portador de oftalmomiíase externa, discorrendo sobre o quadro clínico, os diagnósticos diferenciais e as opções de tratamento. As informações foram obtidas por meio de revisão do prontuário, entrevista com o paciente e registro fotográfico dos métodos diagnósticos e terapêuticos aos quais o paciente foi submetido. Dados foram analisados junto a uma extensa revisão da literatura. O nosso artigo relata um caso de um paciente que foi inicialmente diagnosticado e tratado como celulite pré -septal e após avaliação de especialista em oculoplástica foi realizado o diagnóstico e tratamento adequado para oftalmomiíase. Também revela a importância deste diagnóstico, infrequente nos grandes centros urbanos, seu tratamento e evolução.

ABSTRACT The purpose of this report is to describe a case of external ophthalmomyiasis, discussing the clinical picture, differential diagnoses and treatment options. The information was obtained by means of a review of the medical record, an interview with the patient and a photographic record of the diagnostic and therapeutic methods to which the patient was submitted. Data were analyzed together with an extensive review of the literature. Our article reports a case of a patient who was initially diagnosed and treated for pre-septal cellulitis and after evaluation by a specialist in oculoplastics, the diagnosis and appropriate treatment for ophthalmomyiasis was performed. It also reveals the importance of this diagnosis, infrequent in large urban centers, its treatment and evolution.