1/74. A case of bacterial endophthalmitis following perforating injury caused by a cat claw.A case of bacterial endophthalmitis following a perforating ocular injury caused by a cat claw is reported. The scleral wound was sutured immediately following the injury and systemic antibiotics were administered. Despite this treatment, endophthalmitis occurred 3 days after the injury. The endophthalmitis was resolved by pars plana vitrectomy, however preretinal reproliferation and retinal detachment subsequently occurred. After reoperation the retina was reattached and the corrected visual acuity improved from 10 cm/HM to 20/200. pseudomonas aeruginosa was detected in cultured vitreous humor that was collected during surgery. This case illustrates the possibility of endophthalmitis being caused by gram negative bacillus in cases of perforating injuries caused by animal claws. Perforating ocular injuries caused by animal claws are relatively rare. Here we report a case of endophthalmitis due to pseudomonas aeruginosa that occurred after a perforating injury caused by a cat claw. The eye was treated by pars plana vitrectomy.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
2/74. Cyanoacrylate tissue adhesive augmented tenoplasty: a new surgical procedure for bilateral severe chemical eye burns.PURPOSE: To report on cyanoacrylate tissue adhesive augmented tenoplasty, a new surgical procedure for bilateral severe chemical eye injuries. methods: A 26-year-old man presented with bilateral severe (grade IV) chemical burns involving the eye, periorbital tissues, face, and neck. Despite adequate medical therapy, corneal, limbal, and scleral ulceration progressed in both eyes. Secondary Pseudomonas keratitis necessitated therapeutic penetrating keratoplasty in the right eye. Tenoplasty and glued-on rigid gas permeable contact lens were unsuccessful to arrest progression of corneolimboscleral ulceration in the left eye. We applied n-butyl cyanoacrylate tissue adhesive directly on the ulcerating corneal, limbal, and scleral surface to augment tenoplasty. RESULTS: The left ocular surface healed with resultant massive fibrous tissue proliferation and symblepharon on the nasal side. Ocular surface rehabilitation resulted in a vascularized leukomatous corneal opacity with upper temporal clear cornea. The patient achieved visual acuity of 6/36 in the left eye. CONCLUSION: We suggest that cyanoacrylate tissue adhesive-augmented tenoplasty can be undertaken to preserve ocular integrity and retain visual potential in a severe chemical eye injury.- - - - - - - - - - ranking = 2keywords = visual (Clic here for more details about this article) |
3/74. The treatment of Pseudomonas keratoscleritis after pterygium excision.PURPOSE: To assess the effect of intensive topical and intravenous antibiotics plus oral prednisolone and surgical debridement in Pseudomonas keratoscleritis after pterygium excision. methods: We describe three cases of P. aeruginosa-induced keratoscleritis occurring 10 days to 18 months after uncomplicated pterygium excision. Treatment included early conjunctival debridement, topical and intravenous antibiotics, and low-dosage oral prednisolone. RESULTS: All three patients responded to the combined therapy. Microorganisms were eliminated, and ulcers were healed within 8 weeks. Treatment was not extended beyond that, and infection did not recur. No evisceration was required. The patients' best corrected visual acuities are 20/200, 20/400, and 20/120, respectively. CONCLUSION: early diagnosis and prompt, intensive medical and surgical treatment may save a patient's vision and forestall evisceration.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
4/74. If you can't stand the rash, get out of the kitchen: an unusual adverse reaction to ciprofloxacin.ciprofloxacin, a quinolone antibiotic, is used to treat a wide variety of infections including pseudomonas aeruginosa in patients with cystic fibrosis (CF). Photosensitivity is a well-known complication of treatment with this group of antibiotics, and it is more common in patients with CF. We report on a case of photosensitivity induced by indoor fluorescent strip-lighting (spectral range, 295-760 nm) in a 12-year-old girl with CF treated with ciprofloxacin. This type of lighting emits UVA rays (320-400 nm) which cause skin damage in the presence of sensitizing agents. patients taking ciprofloxacin are usually advised to protect their skin from direct sunlight. We suggest that more attention should be paid to indoor sources of UV light.- - - - - - - - - - ranking = 38.519998535502keywords = sensitivity (Clic here for more details about this article) |
5/74. hypersensitivity to inhaled TOBI following reaction to gentamicin.cystic fibrosis (CF) is the most common autosomal-recessive disease in Caucasians. Colonization with pseudomonas aeruginosa (P. aeruginosa) of the CF airways causes deterioration of pulmonary status. TOBI (tobramycin solution for inhalation) is an inhaled antibiotic that can improve the pulmonary disease. We report on a 9-year old boy with CF who developed a rash following a course of IV gentamicin. The rash resolved after its discontinuation. However, the rash returned all over his body, with the start of inhalation of TOBI therapy. We desensitized the patient using escalating doses of inhaled TOBI. He tolerated the procedure well, and continues to be on TOBI 9 months after desensitization on a once-a-day regimen.- - - - - - - - - - ranking = 77.039997071003keywords = sensitivity (Clic here for more details about this article) |
6/74. Pseudomonas putrefaciens as a cause of infection in humans.Pseudomonas putrefaciens, a strongly H2S-producing pseudomonad, was isolated from 10 human infections over a two-year period. In one patient the organism was repeatedly isolated from a phlegmone developing in the depth of a varicose leg ulcer. This is the first report on the occurrence of Ps. putrefaciens in humans outside the USA and the first to provide the detailed account of a clinical observation where the opportunistic pathogenic role of this unfamiliar organism has been sufficiently documented. Data are presented on the bacteriological properties and on the antibiotic sensitivity of Ps. putrefaciens.- - - - - - - - - - ranking = 19.259999267751keywords = sensitivity (Clic here for more details about this article) |
7/74. Pseudomonas corneal ulcer related to overnight orthokeratology.PURPOSE: To report two cases of pseudomonas aeruginosa corneal ulcers as a complication of overnight orthokeratology lens wear. methods: Case report. RESULTS: Two 11-year-old girls with acute central corneal ulcers were referred to our hospital. In both cases, the ulcers were about 2 mm in diameter, located centrally, contained dense cellular infiltration, and discharged purulent material. Intensive topical ceftazidime was applied to treat the ulcers. Cultures of the scraped corneal tissues and the contact lens storage solutions in both cases grew P. aeruginosa, which was sensitive to the antibiotic. The presenting best-corrected visual acuity was hand motion at 20 cm in one patient and 6/20 in the other. Both patients had received several months of overnight orthokeratology treatment with rigid gas permeable contact lenses to correct myopia (-4.25 D and -4.75 D in the two affected eyes). The final best-corrected visual acuity was 6/60 in one patient and 6/7.5 in the other. CONCLUSIONS: Overnight orthokeratology contact lens wear carries a potential risk of corneal ulcer and may cause significant visual impairment in children.- - - - - - - - - - ranking = 3keywords = visual (Clic here for more details about this article) |
8/74. Orthokeratology lens-related pseudomonas aeruginosa infectious keratitis.PURPOSE: To report a case of orthokeratology lens-related Pseudomonas corneal ulcer in an adult. methods: Case report. RESULTS: A 37-year-old man presented with a 1-day history of painful red eye. He was a soft contact lens wearer before he started on nocturnal orthokeratology lens wear of 8 to 10 hours per night 9 months ago. Corneal scraping sent for culture revealed a heavy growth of pseudomonas aeruginosa. The patient was treated with intensive topical fortified tobramycin and ceftazidime drops. The ulcer healed with a residual paraxial corneal scar. Although his best-corrected visual acuity (BCVA) recovered from finger counting (8/200) at presentation to 20/30, he suffered visual loss from a premorbid BSCVA of 20/15. His contrast sensitivity (Vector Vision CSV 1000 test) performance was also worse than his fellow eye. CONCLUSION: Nocturnal orthokeratology lens wear may be associated with an increased risk of infection.- - - - - - - - - - ranking = 21.462537480705keywords = sensitivity, visual, contrast (Clic here for more details about this article) |
9/74. endophthalmitis with klebsiella pneumoniae liver abscess.Endogenous endophthalmitis is a rare, but devastating complication of septicemia. The prognosis of maintaining visual acuity in patients with septic endophthalmitis is poor in spite of an early diagnosis and the timely start of conventional therapeutic procedures because the intravitreous drug concentration remains low after the systemic administration of antibiotics due to the blood-ocular barrier. We treated an elderly female patient with endogenous endophthalmitis complicated with disseminated intravascular coagulation associated with a klebsiella pneumoniae liver abscess. endophthalmitis developed rapidly and we thus had to perform an enucleation of both eyeballs even though we made an early diagnosis and performed liver abscess drainage as well as the prompt systemic and subconjunctival administration of antibiotics. Our experience in treating this case emphasizes the need to perform the timely intravitreous infusion of antibiotics with a support therapy consisting of the systemic and subconjunctival administration of antibiotics for endogenous endophthalmitis associated with a klebsiella pneumoniae liver abscess.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
10/74. Clinical application of direct sputum sensitivity testing in a severe infective exacerbation of cystic fibrosis.A 16-year-old male with cystic fibrosis (CF) was admitted to hospital with a severe infective exacerbation. Despite standard management, including conventionally selected intravenous antibiotics for pseudomonas aeruginosa, chest physiotherapy, and institution of noninvasive ventilation (NIV) for progressive hypercapneic respiratory failure, he continued to deteriorate. Direct sputum sensitivity testing (DSST) revealed a novel combination of antibiotics that resulted in a rapid and remarkable clinical improvement. DSST is a form of "whole" sputum sensitivity testing that provides information on antibiotic synergy, and may more accurately reflect in vivo antibiotic sensitivity patterns in cystic fibrosis.- - - - - - - - - - ranking = 134.81999487426keywords = sensitivity (Clic here for more details about this article) |
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