ABSTRACT
Caso clínico: Hombre de 38 años remitido de otro centro por presentar queratitis fúngica por Alternaria 25 días después de realizarle una queratoplastia penetrante postraumática en ojo derecho. Se instaura tratamiento con voriconazol tópico y oral con buena evolución posterior. Discusión: Las queratitis fúngicas por Alternaria son poco frecuentes. Su tratamiento es difícil porque la evolución clínica no se correlaciona con la susceptibilidad in vitro del hongo. Producen cuadros clínicos que requieren un rápido diagnóstico y tratamiento, para evitar la pérdida de visión. La combinación de voriconazol tópico y sistémico puede ser una buena alternativa en caso de hongos resistentes al tratamiento convencional
Clinical case: A 38-year-old man with fungal Alternaria keratitis was referred from another hospital 25 days after post-traumatic penetrating keratoplastia surgery on his right eye. We commenced treatment with topical voriconazole and the condition resolved. Discussion: Fungal Alternaria keratitis is rare, and treatment is difficult because the clinical response does not correlate well with the antibiotic in vitro sensitivity of the fungus. Clinical cases need to be diagnosed and treated quickly if visual loss is to be avoided. The combination of topical and systemic voriconazole has been shown to be an effective treatment for this condition (Arch Soc Esp Oftalmol 2008; 83: 493-496)
Subject(s)
Humans , Male , Adult , Keratitis/diagnosis , Keratitis/therapy , Alternaria/isolation & purification , Alternaria/physiology , Alternaria/pathogenicity , Keratoplasty, Penetrating/methods , Immunosuppression Therapy/methods , Keratoplasty, Penetrating/pathology , Keratoplasty, Penetrating/trends , Keratoplasty, Penetrating , Eukaryotic Cells/pathologyABSTRACT
CLINICAL CASE: A 38-year-old man with fungal Alternaria keratitis was referred from another hospital 25 days after post-traumatic penetrating keratoplastia surgery on his right eye. We commenced treatment with topical voriconazole and the condition resolved. DISCUSSION: Fungal Alternaria keratitis is rare, and treatment is difficult because the clinical response does not correlate well with the antibiotic in vitro sensitivity of the fungus. Clinical cases need to be diagnosed and treated quickly if visual loss is to be avoided. The combination of topical and systemic voriconazole has been shown to be an effective treatment for this condition
Subject(s)
Alternaria , Antifungal Agents/administration & dosage , Eye Infections, Fungal/drug therapy , Keratitis/drug therapy , Mycoses , Pyrimidines/administration & dosage , Triazoles/administration & dosage , Administration, Oral , Adult , Eye Infections, Fungal/microbiology , Eye Injuries/surgery , Humans , Keratitis/microbiology , Keratoplasty, Penetrating , Male , Mycoses/drug therapy , Ophthalmic Solutions , Time Factors , Treatment Outcome , VoriconazoleABSTRACT
No disponible
Subject(s)
Rabbits , Animals , Humans , Ophthalmologic Surgical Procedures , Biological Dressings , Cytokines , Cryopreservation , Cell Movement , Cornea , Conjunctiva , Amnion , Inflammation , Epithelial Cells , Growth SubstancesABSTRACT
PURPOSE: To evaluate the anterior chamber configuration by means of ultrasound biomicroscopy in patients with glaucoma and control subjects, and to determine quantitative changes in this configuration after glaucoma filtration surgery (trabeculectomy) and combined cataract and filtration surgery. METHODS: The study included 33 eyes of 33 patients with glaucoma (diagnosed with primary open-angle or exfoliative glaucoma) in which filtration surgery (n = 17) or combined cataract and filtration surgery (n = 16) was performed, and 25 eyes of 25 age-matched control subjects. Ultrasound biomicroscopy was used to measure anterior chamber depth and the angle width at 500 microm from the scleral spur in all eyes. The patients with glaucoma were examined 2 days before surgery and 3 and 6 months after surgery. RESULTS: There were no significant differences in anterior chamber depth and angle width between patients with glaucoma before surgery and control subjects. Postoperative values for anterior chamber depth were significantly greater in patients with glaucoma who underwent combined surgery, but no significant changes were observed in those who underwent filtration surgery alone. In contrast, angle width was significantly greater after surgery both in patients who underwent combined surgery and in those who underwent filtration surgery alone. CONCLUSION: On ultrasound biomicroscopic evaluation, there were no differences in anterior chamber depth and angle width between patients with glaucoma and control subjects. Trabeculectomy alone widens the angle but does not affect the anterior chamber depth; however, combined surgery both deepens the anterior chamber depth and widens the angle.
Subject(s)
Anterior Chamber/diagnostic imaging , Glaucoma, Open-Angle/surgery , Trabeculectomy , Aged , Aged, 80 and over , Anterior Chamber/surgery , Cataract Extraction , Exfoliation Syndrome/complications , Female , Glaucoma, Open-Angle/diagnostic imaging , Glaucoma, Open-Angle/etiology , Humans , Male , Middle Aged , Postoperative Period , Prognosis , Prospective Studies , UltrasonographyABSTRACT
Fungi belonging to the genus Acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremoniumpotronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin B was unsuccessful and the infection eventually resolved with penetrating keratoplasty.
Subject(s)
Acremonium/isolation & purification , Eye Infections, Fungal/complications , Herpesvirus 1, Human/isolation & purification , Keratitis, Herpetic/complications , Keratitis, Herpetic/microbiology , Mycoses/complications , Adult , Antibodies, Viral/analysis , Antifungal Agents/therapeutic use , Corneal Stroma/microbiology , Diagnosis, Differential , Eye Infections, Fungal/microbiology , Eye Infections, Fungal/therapy , Herpesvirus 1, Human/immunology , Humans , Keratitis, Herpetic/therapy , Keratoplasty, Penetrating , Male , Mycoses/microbiology , Mycoses/therapyABSTRACT
The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.
