Aspergillus endophthalmitis in orthotopic liver transplantation.

In this report, we describe a patient with drug-induced liver failure who developed endogenous endophthalmitis after liver transplantation. Our patient's clinical course was so fulminant that the eye was lost in less than 1 month, without any response to therapy. Recognition of this infection is important because many patients die of disseminated Aspergillus infection, which may be detected early with bedside funduscopic examination by an ophthalmologist. Probably if the patient had referred to us earlier, it may have been possible to save the eye.

Rhinosporidiosis in Raipur, Chhattisgarh: a report of 462 cases.

Rhinosporidiosis is endemic in the state of Chhattisgarh. 462 cases were encountered during the period of 12 years from January 1994 to December 2005. Maximum incidence was seen in men in the age group of 21-30 years. Nose and nasopharynx were the commonest site (81.1%), followed by ocular tissue (14.2%). Many rare sites of involvement were encountered. Seven cases of generalized rhinosporidiosis were seen. Rhinosporidium seeberi could be easily identified in Haematoxylin and eosin stained sections. Sporangias and spores are better delineated by periodic Acid Schiff, Mayer's mucicarmine, Verhoff's vonGieson and Grocott Gomori methamine silver stain.

Microbiota indígena de seres humanos / Indigenous microbiota of human beings

As superfícies do corpo humano são colonizadas por uma comunidade de organismos, principalmente bactérias, que constitui a microbiota indígena. A composição desta microbiota se altera ao longo da vida e é influenciada por diversos fatores, tais como dieta e status imunológico do hospedeiro. A microbiota pode agir de maneira benéfica ou, em algumas situações, pode ser prejudicial para o indivíduo. Podem ser distinguidas a microbiota residente, constituída por organismos específicos, encontrados, freqüentemente, em determinadas áreas e a microbiota transitória, que consiste de microrganismos provenientes do ambiente, que habitam a pele e as superfícies mucosas por horas ou poucas semanas. Trato gastrointestinal, vagina, cavidade oral e pele possuem a microbiota mais rica e diversificada do corpo humano. O conhecimento da constituição da microbiota indígena é extremamente relevante para os médicos, principalmente para orientar a interpretação de resultados de exames microbiológicos e a escolha da terapia antimicrobiana empírica mais adequada. Deve-se salientar que a microbiota geralmente é benéfica. Por esse motivo, é fundamental que se tenha consciência dos riscos do rompimento da homeostasia entre microbiota e hospedeiro.

Body surfaces are colonized by a community of organisms that are recognized as indigenous microbiota, that is mainly constituted by bacteria. Its constitution changes with time and is influenced by several conditions such as diet and the immune status of the individual, among others. There are now evidences that the microbiota could be beneficial or, in some instances, dangerous to human health. It could be classified as resident, composed by fixed organisms, frequently found in certain areas, or as transitory, consisting of organisms from the environment that inhabits skin and mucosa for hours to few weeks. The gastrointestinal tract, vagina, oral cavity and skin show the richest and most diverse microbiota of the human body. The knowledge of the constitution of the indigenous microbiota is extremely important for clinicians, mainly because it can help them to interpret results of microbiological tests and to choose appropriate empirical therapy. It should be pointed out that microbiota is, in general, harmless and beneficial; for these reason, physicians must keep in mind that the disruption of the homeostasis between microbiota and host should be avoided.

Proliferaciones algales nocivas de cianobacterias (Oscillatoriaceae) y dinoflagelados (Gymnodiniaceae) en el Golfo de Nicoya, Costa Rica / Harmful blooms of cyanobacteria (Oscillatoriaceae) and dinoflagellates (Gymnodiniaceae) in the Golfo de Nicoya, Costa Rica

Recently, the Pacific coast of Costa Rica has experienced an increase in both magnitude and frequency of harmful algae blooms (HAB). The lack of data regarding the dynamics of these events in the area, and the species of microalgae that produce them, are themes of great interest. The blooms have produced negative impacts on fishery resources and on human health in Costa Rica. In May 2002 a HAB left a large number of dead fish along the central Pacific coast. Water samples were collected using a phytoplankton net and fixed for subsequent processing by electron microscopy. In addition, a one liter sample of surface water was taken for later cell count. In the observed HAB, the dominating organisms found were the cyanobacteria Trichodesmiun erythraeum surrounded by high concentrations of Gram - bacteria and the dinoflagellate Cochlodinium cf. polykrikoides. T. erythraeum, is one of the most important N 2 fixing cyanobacteria in marine waters that has been associated with HAB events in diverse parts of the world as well as with symptoms that produce contact dermatitis and other discomforts. C. cf. polykrikoides is a dinoflagellete associated with fish kills; although the type of associated toxins are unknown. In a national newspaper 17 cases of intoxication in humans were reported during this same period, which presented respiratory disorders and burning of the eyes. This is the first report in Costa Rica where a cyanobacteria and a dinoflagellate were observed together producing HAB

Recientemente, la costa del Pacífico de Costa Rica ha experimentado un aumento en magnitud y frecuencia de proliferaciones algales nocivas (PAN). La falta de datos con respecto a la dinámica de estos eventos en el área, y las especies de microalgas que los producen, son temas de mucho interés. Las PAN han producido impactos negativos en los recursos pesqueros y en la salud humana en Costa Rica. En mayo de 2002, una PAN se observó frente a las playas a lo largo del Pacífico central; además, se observó un gran número y diversidad de peces muertos. Las muestras de agua fueron recolectadas usando una red de fitoplancton y se fijaron para ser procesadas posteriormente con microscopía electrónica. Asimismo, se tomó un litro de muestra de la superficie para su posterior conteo celular. En la PAN observada, los organismos dominantes fueron la cianobacteria Trichodesmiun erythraeum, rodeada por altas concentraciones de bacterias Gram -, y el dinoflagelado Cochlodinium cf. polykrikoides. T. erythraeum, es una de las principales cianobacterias fijadoras de N2 atmosférico en aguas marinas, y se ha asociado con los eventos PAN en diversas partes del mundo, produciendo síntomas como dermatitis por contacto con la brisa marina y otras afecciones. C. cf. polykrikoides es un dinoflagelado asociado con mortalidad de peces; aunque el tipo de toxinas asociadas aún es desconocido. En un periódico nacional se reportaron 17 casos de intoxicación en humanos durante este mismo periodo de PAN, los afectados presentaron desórdenes respiratorios e irritación en los ojos. Éste es el primer informe en Costa Rica dónde se observaron cianobacterias y dinoflagelados juntos produciendo PAN. Este tipo de fenómenos debe analizarse y debe documentarse, para habilitar una comprensión en la dinámica y los factores asociados con el aumento de estos eventos en el Pacífico costarricense

Bacteriology of ophthalmic infections with special reference to anaerobes.

A total of 138 eye specimens were processed for aerobic and anaerobic cultures. Clinical data were obtained from 50 patients with unilateral ophthalmic infection. Cultures from the uninfected eye of 38 of these 50 patients were also processed for comparison. In addition, 50 cultures were obtained from one or both eyes of 30 healthy controls who had no eye infection. Anaerobes and aerobes were isolated from infected eyes of 6 (12%) and 37 (74%) patients respectively. No growth was observed in infected eye of 8 (16%) patients. A mixture of aerobes and anaerobes were recovered only in 2 cases. Of the total 47 aerobic isolates from infected eye specimens, Staphylococcus aureus (11), coagulase negative staphylococci (12) and Streptococcus pneumoniae (9) were predominant isolates. Six anaerobes isolates included Gram positive nonsporing anaerobic bacilli (4 including Propionibacterium acne) as predominant isolates. Clostridium perfringens was isolated from a case of post operative endoophthalmitis. From the uninfected eye of same patients though the number and types of aerobic bacteria were similar, none grew any anaerobes. Aerobic and anaerobic bacteria were isolated in 70 and 6 per cent of eye swabs respectively from the healthy controls.

Avaliaçäo de contaminaçäo de produtos oftalmicos em uso / Evaluation of contamination of in-use ophthalmic medications

Objetivando verificar a incidência da contaminaçäo de produtos oftálmicos em uso numa clínica oftalmológica americana, foram cultivadas tais soluçöes, assim como a parte interna da tampa e o bico dos colírios. Também foram cultivados materiais provenientes dos olhos dos pacientes a fim de verificar-se a procedência da possível contaminaçäo de 21,2//. Os microrganismos mais encontrados foram: Estafilococos sp., Enterobacter sp., Klebsiela pneumoniae, Candida sp., Proteus sp. e Citobacter sp.

Eficácia clínica e microbiológica da norfloxacina tópica 0,3 no tratamento de infecçöes oculares externas / Clinical and microbiological effectiveness of topical norfloxacin 0,3

Foi avaliada a eficácia clínica e microbiológica da norfloxacina a 0,3% contra 24 cepas de Staphylococcus aureus e 15 cepas de anaeróbios isolados de 27 pacientes portadores de infecçäo ocular superficial externa. Comparou-se a eficácia microbiológica da norfloxacina com as da gentamicina, tobramicina, cloranfenicol, ciprofloxacina, ácido nalidíxico, ofloxacina, cefalotina e associaçäo de antibióticos (oftrim), vancomicina e amicacina no pré e pós-tratamento com norfloxacina tópica 0,3%. Obteve-se eficácia clínica com o tratamento tópico em 83,3% dos pacientes portadores de infecçäo ocular superficial externa por S. aureus. Nenhum microrganismo anaeróbio foi sensível à norfloxacina

Amebic infection of the eye

A 60-year-old male with previous filtration operation developed severe ocular infection 6 hours after splashing his eyes with tap water. Swab from the fornix demonstrated ameba proteus. A 17-year-old girl, wearing soft contact lens, suddenly developed irritation in the right eye and later on developed characteristic opaque corneal ring in the mid-periphery due to acanthamoeba. A young male developed chronic corneal ulcer which did not respond to any medical treatment. He had penetrating corneal graft. Histological examination of the corneal button demonstrated trophozoite stage of acanthamoeba