ABSTRACT
INTRODUCTION: We described a case of a pseudomonas aeruginosa subperiosteal abscess in a healthy adult, complicated by ophthalmic artery occlusion. CASE PRESENTATION: A 41-year-old woman presented with the chief complaint of a severe painful left eyelid. The visual acuity was limited to light perception. Fundus examiantion showed diffuse retinal edema, papillary swelling and whitened retinal vessels without cherry-red spot. Multimodal imaging confirmed the diagnosis of ophthalmic artery occlusion. Computed tomography study was performed and objectified a pansinusitis complicated by left orbital cellulitis and a 7.4mm × 29.8 mm subperiosteal abscess (SPA). In addition to intravenous antibiotics, surgical drainage of the SPA was performed. The bacterial culture of the abscess has shown growth of Pseudomonas aeruginosa and laboratories studies did not find any cause of immunodeficiency. Although medical and surgical treatment, the retinal damage was irreversible with visual acuity limited to light perception. CLINICAL DISCUSSION: The developing of a subperiosteal abscess (SPA) of the orbit is a serious complication that arises usually from bacterial sinusitis and can lead to sight threatening complications. Pseudomonas aeruginosa is not common in healthy adults. An early diagnosis and an adequate treatment are important for the visual prognosis. CONCLUSION: Orbital cellulitis should be diagnosed and treated promptly, even in healthy people, to improve visual prognosis.
ABSTRACT
PURPOSE: To analyze the epidemiological and clinical features of Acanathamoeba keratitis AK and to assess the risk factors of this corneal infection in contact lens CL wearers in a tertiary center of Tunisia, North Africa. METHODS: We carried out a retrospective study between January 2008 and December 2019 in the ophthtalmology department of a referral center, Sousse, Tunisia. A review of the chart of 248 patients using CL and diagnosed with presumed infectious keratitis was done.Socio demographic, risk behaviors and microbiological findings in case of AK were analyzed. The mean follow-up was 18 months (1 month-4 years). RESULTS: AK was diagnosed in 29 cases (11.7% of contact lens wearers with infectious keratitis). These 29 cases were analyzed. The mean age at the time of diagnosis was 33, 44 ± 26, 9 years. Almost of the patients (13; 44.82%) used soft monthly disposable contact lenses. Some risk behaviors related to contact lens wearing were found in our study like not washing and drying hands before CL wear, sleeping in CL, topping off, not respecting the adequate replacement frequency and showering or swimming in CL.After treatment, visual acuity improved only in 10 cases (34.48%), remained the same in 11 cases (37.93%) and worsened in 8 cases (27.58%). CONCLUSION: Clinicians must suspect AK in each CL wearer with suggestive clinical signs to allow earlier treatment and better prognosis. Public prevention messages that encourage CL wearers to respect the hygiene rules should be broadly applicable to each person using any type of CL, to minimize the risk of AK.
ABSTRACT
INTRODUCTION: Renal involvment of Behçet disease is not usual and Ig A vasculitis complicated by Behçet disease is extremely rare. CASE PRESENTATION: We report a case of Henoch Scholein purpura and nephritis associated with Behçet disease revealed by ophthalmic examination. CLINICAL DISCUSSION: Recurrent oral ulcer is not a manifestation of Ig A vasculitis which doesn't affect large or middle sized arteries. If the patient had'nt been referred to our department for ophthalmic examination, we may have failed to make the diagnosis and treat coexisting Behçet disease. CONCLUSION: The link of HSP and BD has yet to be fully understood, and more researchisdefinitelyneeded.
