RESUMO
We report an atypical case of unilateral thyroid eye disease in an elderly euthyroid male in which ultrasound was useful in the diagnosis, when computed tomography (CT) scan and magnetic resonance imaging (MRI) were ambiguous.
Assuntos
Doença de Graves/diagnóstico por imagem , Idoso , Doença de Graves/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Músculos Oculomotores/diagnóstico por imagem , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
PURPOSE: To present a case of bilateral Acanthamoeba keratitis in a patient who stored both contact lenses in the same storage case. METHODS: The case report of a 44-year-old female contact lens wearer who developed bilateral culture-positive Acanthamoeba keratitis. Although an experienced contact lens user for many years, she admitted to occasionally rinsing her dual contact lens case in tap water and leaving it to air dry. She was successfully treated with intensive topical polyhexamethyl biguanide and propamide isethionate in conjunction with a mydriatic agent, topical ofloxacin, and oral flurbiprofen. RESULTS: The Acanthamoeba keratitis resolved without sequelae. After 6 months, the patient had a visual acuity of 20/20 in each eye. CONCLUSIONS: Although bilateral Acanthamoeba keratitis is rare, it is essential that the patient is properly educated in contact lens hygiene and disinfection. Regular contact lens follow-up of patients is essential, and lens storage and disinfection techniques must be reviewed with the patient. The use of single-use contact lens storage cases may be advantageous in reducing the incidence of bilateral disease after case contamination.
Assuntos
Ceratite por Acanthamoeba/etiologia , Acanthamoeba/isolamento & purificação , Lentes de Contato/efeitos adversos , Ceratite por Acanthamoeba/diagnóstico , Ceratite por Acanthamoeba/tratamento farmacológico , Doença Aguda , Adulto , Amebicidas/administração & dosagem , Animais , Soluções para Lentes de Contato , Lentes de Contato/parasitologia , Diagnóstico Diferencial , Equipamentos Descartáveis , Feminino , Seguimentos , Humanos , Soluções Oftálmicas/administração & dosagemRESUMO
The incidence of cross-reaction after subconjunctival cefuroxime following cataract surgery in penicillin allergy patients is not common and therefore cefuroxime with its better spectrum of action and lower toxicity is probably a better choice than gentamycin.
Assuntos
Antibioticoprofilaxia , Extração de Catarata , Cefuroxima/administração & dosagem , Túnica Conjuntiva/efeitos dos fármacos , Hipersensibilidade a Drogas/prevenção & controle , Penicilinas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cefuroxima/imunologia , Túnica Conjuntiva/imunologia , Hipersensibilidade a Drogas/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Penicilinas/imunologia , Estudos RetrospectivosRESUMO
BACKGROUND: Pseudomonas keratitis can result in the breakdown of collagen with subsequent corneal melting and perforation. The use of antimetalloproteinases may help to stabilize melting and prevent imminent perforation of the cornea. The use of topical protease inhibitors and neutrophil inhibitors is of limited value. Tetracyclines, however, have been shown to have anticollagenolytic activity and inhibit metalloproteinases, and they may suppress connective tissue breakdown. PURPOSE: To establish the stabilization of corneal melting in cases of Pseudomonas keratitis. METHODS: Two young patients with severe contact lens-associated Pseudomonas keratitis and corneal melting were treated with oral doxycycline and standard topical treatment. RESULTS: Corneal melting was stabilized in each patient, and perforation was avoided. CONCLUSIONS: Tetracyclines have an anticollagenolytic action in addition to their antimicrobial activity. The use of doxycycline as an adjunctive therapy in the management of Pseudomonas corneal melting may help to stabilize corneal breakdown and prevent subsequent perforation.
