RESUMEN
Zygomycosis is rare but highly invasive fungal infection, with high mortality rate. A 67 years old diabetic man was presented with rhino-ocular form of the disease. Fungal elements invaded the skin and subutaneous facial tissue, with involvement of the nose, paranasal sinuses and orbit. The portal of entry of fungus was through paranasal sinuses, after the tooth extraction. Various clinical manifestations were presented: headache, facial swelling, tenderness over the involved sinuses, unilateral orbital cellulitis with proptosis, facial and orbital pain, black nasal discharge, decreased visual acuity, blindness. Patient was treated surgically and by liposomal amphotericin B. He underwent maxillectomy, ethmoidectomy and sphenoidectomy and orbital exenteration because of the dissemination of the disease into the orbit. The specific diagnosis of the infection was established upon the microscopic demonstration of casual agent in the debridement tissue. Early diagnosis was important in this highly fatal disease. Aggressive surgical debridement, therapy with amphotericin B and correction of underlying metabolic acidosis must be performed. The successful medical therapy in this patient suggests that lipid formulation of amphotericin B should be given, because this antifungal agent performed the best control of the infection with the minimal adverse effects.
Asunto(s)
Enfermedades Nasales , Enfermedades Orbitales , Enfermedades de los Senos Paranasales , Cigomicosis , Anciano , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Humanos , Masculino , Enfermedades Nasales/diagnóstico , Enfermedades Nasales/etiología , Enfermedades Nasales/terapia , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/etiología , Enfermedades Orbitales/terapia , Enfermedades de los Senos Paranasales/diagnóstico , Enfermedades de los Senos Paranasales/etiología , Enfermedades de los Senos Paranasales/terapia , Extracción Dental/efectos adversos , Cigomicosis/diagnóstico , Cigomicosis/etiología , Cigomicosis/terapiaRESUMEN
Retrospective analysis of the medical documentation of 506 wounded treated at the Ophtalmological Clinic of the Military Medical Academy, was used to separate the cases where, due to the injury, the eyesight was destroyed or reduced to "the sense and projection of the light". The groups were formed according to the mechanism of injury and etiological factor. In 41.03% of eyes described sight impairment was established on admission, and the perforative injury of the eye was the basic etiological factor in 64.26% of the cases.
Asunto(s)
Ceguera/etiología , Lesiones Oculares/complicaciones , Guerra , Lesiones Oculares/etiología , Humanos , Estudios Retrospectivos , YugoslaviaRESUMEN
The analysis of 210 patients with penetrating eye injuries was performed. The age of the majority of injured was 20-30 (40%). Most injuries were caused by explosive devices (80%). Entering wounds were found on the cornea in 66.19%, on the sclera in 21.42% and on the limbus in 12.38% of the cases. Traumatic cataract was found in 45.72%, hemophthalmus in 53.33%, detachment of the retina in 40%, intrabulbar foreign body in 51.42%, prolapse of the iris and uvea in 36.19%, and endophthalmitis and hypopyon in 11.42% of the cases. Visual acuity after the operation was more than 0.10 in 37.89% of the cases. The basic principles of the treatment of penetrating eye war injuries were discussed.
Asunto(s)
Lesiones Oculares Penetrantes/terapia , Guerra , Adulto , Bosnia y Herzegovina , Lesiones Oculares Penetrantes/etiología , Humanos , Persona de Mediana EdadRESUMEN
Surgical treatment of paralytic convergent strabismus using the modified Jensen's is method was performed in 35 patients. The full success (orthophoria) was achieved in 51.5% and satisfying (approximately orthophoria) in 25.7% of cases. The six-year follow up of patients showed that surgical effect was permanent in 71.4% of cases. The most common cause of paralytic convergent strabismus has been trauma (71.4%), and, that, traffic accidents in 45.7%. According to communications and available literature this modified treatment of paralytic convergent strabismus for the first time in Yugoslavia has been applied in the Military Medical Academy.