ABSTRACT
PURPOSE: To identify the characteristics and frequency of ocular findings in Japanese children with Down syndrome. METHODS: A total of 304 Japanese children with Down syndrome at an average age of 7 years and 4 months were examined for ocular findings from June 2009 to January 2011. RESULTS: Most had hyperopia (69.1%) and astigmatism (58.5%). Both normal and oblique astigmatism were common. Spectacles were necessary in 91.3%. The average visual acuity at 8 years was 0.305 logMAR. Under 6 years, stripe and picture visual acuity charts were useful. Strabismus (36.5%, esotorpia 23.3%), nystagmus (25.7%), stereopsis (46.0%), entropion of eyelids (18.8%), cataract (10.5%), and corneal disease (3 cases) were found. Medullated nerve fibers (3 cases), pseudo disc edema (2 cases), and other retinal changes including Leber congenital amaurosis like chorioretinal degeneration (3 cases) were also found. CONCLUSION: The high incidence of refractive errors and strabisums in Down syndrome were confirmed. These must be treated during the sensitive period of visual development. For other ocular findings intensive ophthalmic care is important for children with Down syndrome from the time of infancy.
Subject(s)
Down Syndrome/complications , Refractive Errors/complications , Strabismus/complications , Adolescent , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
A 65-year-old man with old tuberculous pleuritis was admitted to our hospital because of swelling and heat on the right upper abdomen on December 8, 2006. Computed tomography showed the presence of thickening and calcification of the right pleura, capsular effusion, and soft-tissue swelling of the right upper abdomen. Salmonella Livingstone was isolated from the aspiration specimen of the capsular effusion. Chronic empyema caused by Salmonella Livingstone with soft-tissue abscess was diagnosed, and was treated with 400 mg per day levofloxacin. Salmonella spp. is known as a common pathogen of gastroenteritis. Pleuropulmonary Salmonella infection is rare, and only 5 cases have been reported in Japan. However, this organism can cause respiratory tract infection in a patient with an impaired host defence system such as old tuberculosis.
Subject(s)
Abscess/complications , Empyema/etiology , Salmonella Infections/microbiology , Salmonella/isolation & purification , Soft Tissue Infections/complications , Aged , Empyema/microbiology , Humans , Male , Tuberculosis, Pleural/complicationsABSTRACT
A retrospective study was undertaken to investigate the clinical aspects of Q-fever pneumonia. Six sporadic cases, 5 men and 1 woman, aged between 36 and 81 years were diagnosed by testing paired serum samples using an indirect immunofluorescence assay from July 2004 to June 2007. Of these, 5 suffered from concomitant or chronic disease. The predominant clinical features were fever, cough, sputum, and chest pain. The WBC count was within normal values in half of the patients. C-reactive protein was elevated in all patients. Liver dysfunction was noted in 2 patients. Chest computed tomography revealed air space consolidation and small nodules in all patients and pleural effusion in 1 patient. Anti-phase II IgG titers of paired serum samples were elevated, but anti-phase II IgM titers were within normal limits in all the patients. Antibiotics were given to all the patients, and, beta-lactum agents were prescribed for 3 patients. The outcome was favorable in all the patients. These patients demonstrated nonspecific clinical, radiological, and laboratory manifestations, and we were able to distinguish Q-type pneumonia from other forms of community-acquired pneumonia only by testing anti-phase II IgG titers of paired serum samples.
