- MeSH
- Acyclovir administration & dosage MeSH
- Anti-Bacterial Agents administration & dosage MeSH
- Dexamethasone administration & dosage MeSH
- Endophthalmitis * diagnostic imaging etiology pathology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Ophthalmologic Surgical Procedures * adverse effects MeSH
- Disease Progression MeSH
- Uveitis diagnosis drug therapy pathology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Cílem sdělení je seznámit s formami očních projevů visceral larva migrans u dětí, jak dokresluje rozsáhlá fotodokumentace. Oční larvální toxokaróza (OLT) má i v dětském věku rozdílné klinické projevy, kdy vliv má věkové zastoupení. Nejčastěji bývá přítomen periferní granulom oka často s trakčním vitreálním pruhem táhnoucím se z periferie sítnice k papile zrakového nervu. Následuje granulom zadního pólu oka zasahující většinou od makulární krajiny do střední periferie sítnice vždy s vitritidou. U dětí se může OLT projevit i postižením optického nervu (cystický granulom hlavy zrakového nervu nebo neuropatie s vitritreální reakcí), fulminativní endoftalmitidou a vzácně i difúzní chorioretinitidou. Diagnostika se opírá o klinický oftalmologický nález a také laboratorní vyšetření hladin protilátek s případnou eosinofilií. Histologické vyšetření může prokázat kulovitou polyploidní osifikaci v cévnatce na zadním pólu oka jako následek fibrotizace a kalcifikace postupující z v okolí vstřebané larvy. Celková kombinovaná léčba anthelmetikem a kortikoidem je obtížná, a ne vždy přináší dobrý efekt ve smyslu uspokojivého zlepšení zrakové ostrosti. Projevy OLT u malých dětí jsou stále spojeny v diferenciální diagnóze s retinoblastomem a klinikou dalších nitroočních chorob.
The aim of this paper is to present an outline of forms of ocular manifestations of visceral larva migrans in children, as illustrated by the extensive photographic documentation. Ocular larval toxocariasis (OLT) has various clinical manifestations even in childhood age, in which age representation has an influence. The most common is presence of peripheral granuloma of the eye, frequently with a tractional vitreal streak leading from the retinal periphery to the optic nerve papilla. This is followed by granuloma of the posterior pole of the eye, usually reaching from the macular landscape to the central retinal periphery, always with vitritis. In children OLT may be manifested also in affliction of the optic nerve (cystic granuloma of the head of the optic nerve or neuropathy with vitreal reaction), fulminant endophthalmitis and in rare cases also diffuse chorioretinitis. The diagnosis rests upon a clinical ophthalmological finding, as well as laboratory examination of the levels of antibodies with potential eosinophilia. Histological examination may demonstrate spherical polypoid ossification in the choroid at the posterior pole of the eye as a consequence of fibrotisation and calcification, proceeding from the surrounding area of the absorbed larva. General combined treatment with antihelminthics and corticosteroids is arduous and does not always produce the desired effect in the sense of a satisfactory improvement of visual acuity. In differential diagnostics, manifestations of OLT in small children are still associated with retinoblastoma and a clinical picture of other intraocular diseases.
- MeSH
- Anthelmintics administration & dosage pharmacokinetics therapeutic use MeSH
- Chorioretinitis etiology MeSH
- Diagnosis, Differential MeSH
- Child MeSH
- Enzyme-Linked Immunosorbent Assay methods MeSH
- Endophthalmitis etiology MeSH
- Larva Migrans, Visceral diagnosis etiology MeSH
- Humans MeSH
- Eye pathology MeSH
- Toxocariasis * diagnosis drug therapy prevention & control MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Choroiditis diagnosis etiology drug therapy MeSH
- Endophthalmitis diagnosis etiology therapy MeSH
- Conjunctivitis diagnosis etiology therapy MeSH
- Humans MeSH
- Eye Infections, Bacterial MeSH
- Eye Infections, Fungal MeSH
- Eye Infections, Parasitic MeSH
- Eye Infections, Viral MeSH
- Eye Infections * diagnosis etiology therapy MeSH
- Retinitis diagnosis etiology drug therapy MeSH
- Uveitis diagnosis etiology therapy MeSH
- Check Tag
- Humans MeSH
- MeSH
- Candida pathogenicity MeSH
- Adult MeSH
- Endophthalmitis * diagnosis etiology drug therapy microbiology MeSH
- Fluconazole therapeutic use MeSH
- Immunocompromised Host MeSH
- Humans MeSH
- Methotrexate pharmacology therapeutic use MeSH
- Eye Infections, Fungal * diagnosis etiology drug therapy microbiology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Aims: To describe the aetiology and microbial susceptibility profile of endophthalmitis cases treated at an ophthalmological referral centre in Colombia. Material and Methods: A retrospective descriptive study was carried out with all endophthalmitis cases referred to the Fundación Oftalmológica de Santander FOSCAL (Floridablanca, Colombia) from 1 January 2012 to 31 December 2015. Results: 121 eyes of 121 patients were evaluated. 77.7% of them were male and the mean age was 42.9 years. Five of them (4.1%) corresponded to endogenous endophthalmitis, and 116 (95.9%) to exogenous endophthalmitis. Of the latter, 66.9% were associated with trauma (almost one-half of them associated with intraocular foreign body), and 29.5% with intraocular surgery. The most common isolated microorganisms in the exogenous endophthalmitis group corresponded to methicillin-resistant and methicillin-sensitive strains of Staphylococcus epidermidis and Staphylococcus aureus, which were mostly susceptible to imipenem, vancomycin and moxifloxacin and resistant to ceftazidime. Conclusion: Endophthalmitis is a potentially sight-threatening condition, especially in cases of inadequate treatment. Therefore, antimicrobial therapy should be guided by vitreous humour culture to assure that the causative microorganism is susceptible to the selected agent. The results of our study lead us to propose vancomycin, moxifloxacin or imipenem as first-line antimicrobial options.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Endophthalmitis * epidemiology etiology MeSH
- Imipenem therapeutic use MeSH
- Humans MeSH
- Moxifloxacin therapeutic use MeSH
- Eye Infections, Bacterial drug therapy complications MeSH
- Retrospective Studies MeSH
- Vancomycin therapeutic use MeSH
- Check Tag
- Humans MeSH
Kazuistika popisuje prípad endogénnej endoftalmitídy u 58-ročného muža v priebehu urosepsya bronchitídy. Pacient bol hospitalizovaný na Internej klinike v inej nemocnici. Druhý deň po prijatí bol odoslaný na konziliárne vyšetrenie na našu kliniku pre zhoršenie videnia a bolesti ľavého oka. Stav bol uzavretý ako endogénna endoftalmitída. Zraková ostrosť pri prvom vyšetrení bola pohyb ruky pred okom. Bola zahájená intravitreálna liečba, kombinácia dvoch antibiotík (ceftazidim 2 mg/ 0,1 ml a vankomycín 1 mg/ 0,1 ml)a antimykotika (amfotericín B 10 μg/ 0,1 ml).V priebehu dvoch týždňov dostal takúto antibiotickú liečbu intravitreálne spolu 3x. Počas prvej aplikácie antibiotík sa odobral z prednej očnej komory materiál na mikrobiologické vyšetrenie - výsledok bol negatívny. Z hemokultúry bol vypestovaný zlatý stafylokok.Parenterálna aplikácia antibiotík (gentamycín 240 mg i.v. á 24 hod aamoxicilín s kys. klavulanovou 1,2 g i.v. á 8 hod) trvala 2 týždne, potom pokračovala antibiotická liečba (ciprofloxacín 500 mg á 12 hod) a antimykotická liečba (itrakonazol 100 mg á 12 hod)perorálne 2 mesiace. Štyri týždne po začatí liečenia bola zraková ostrosť ľavého oka 20/100 a po dvoch mesiacoch 20/40. V práci sa zdôrazňuje výhoda multiodborovej spolupráce.
A case report of 58-year-old man with endogenous endophtalmitis due to urosepsis and bronchitis. Patient was hospitalized in Department of Internal Medicine another hospital. He was sent to consiliar examination to our Ophtalmology Department with worsening vision and pain in left eye one day after onset. The diagnose endogenous endophtalmitis was set. Visual aquity was a hand movement on the first visit. Intravitreal therapy was realized promptly that day, a combination of two antibiotic drugs (ceftazidim 2mg/ 0.1 ml a vankomycin 1 mg/ 0.1 ml) and antifungal agent (amfotericin B 10 μg/ 0.1 ml). This therapy was applicated 3x totally, in two weeks. Humour from anterior chamber was taken during first intravitreal application and was negative. Blood culture was positive for staphylococcus aureus. Intravenous treatment with antibiotics (gentamycin 240 mg i.v. á 24hours a amoxicilin with clavulan acid 1.2 g i.v. á 8 hod) was set for two weeks then continued antibiotic (ciprofloxacin 500 mg á 12 hours) and antifungal therapy (itrakonazol 100 mg á 12 hod) per os two months. Visual aquity of the left eye was 20/100 after four weeks and 20/40 after two months. We would like to highlight advantage of multidisciplinary co-operation.
- Keywords
- urosepse,
- MeSH
- Endophthalmitis * drug therapy microbiology MeSH
- Urinary Tract Infections complications MeSH
- Intravitreal Injections methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Staphylococcus aureus MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Endophthalmitis diagnosis etiology therapy MeSH
- Uveitis, Intermediate diagnosis etiology drug therapy MeSH
- Humans MeSH
- Uveal Neoplasms diagnosis pathology therapy MeSH
- Uveal Diseases * diagnosis etiology therapy MeSH
- Uveitis, Anterior diagnosis etiology drug therapy MeSH
- Ophthalmia, Sympathetic diagnosis etiology therapy MeSH
- Uvea anatomy & histology pathology MeSH
- Uveitis diagnosis etiology drug therapy MeSH
- Uveitis, Posterior diagnosis etiology drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Antifungal Agents administration & dosage MeSH
- Endophthalmitis * drug therapy surgery microbiology MeSH
- Immunocompromised Host MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Eye Infections, Fungal MeSH
- Vitrectomy methods MeSH
- Treatment Outcome MeSH
- Uveitis, Posterior drug therapy surgery MeSH
- Heroin Dependence complications MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
