1/7. Resolution of microsporidial sinusitis and keratoconjunctivitis by itraconazole treatment.PURPOSE: To report successful treatment of ocular infection caused by the microsporidium encephalitozoon cuniculi in a person with acquired immunodeficiency syndrome (AIDS) and nasal and paranasal sinus infection. METHOD: Case report. RESULTS: Microsporidial infection in a person with AIDS and with chronic sinusitis and keratoconjunctivitis was diagnosed by Weber modified trichrome stain and transmission electron microscopy. Symptoms completely resolved with itraconazole treatment (200 mg/day for 8 weeks) after albendazole therapy (400 mg/day for 6 weeks) was unsuccessful. CONCLUSION: itraconazole can be recommended in ocular, nasal, and paranasal sinus infection caused by E. cuniculi parasites when treatment with albendazole fails.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
2/7. Epidemic keratoconjunctivitis and chronic papillary conjunctivitis in london due to adenovirus type 19.Since July 1973 cases of keratoconjunctivitis resembling epidemic keratoconjunctivitis were observed in the External eye disease Clinic at Moorfields eye Hospital; City Road, london. Adenovirus type 19 was isolated in human embryonic kidney cells from 21 patients. The majority were males between 20 and 40 years old. A small hospital outbreak involving six patients occurred. Clinical features of the disease, consisting of moderate to severe follicular conjunctivitis, major subepithelial punctate keratitis, sometimes with pseudomembrane and scarring, were closely similar to those of epidemic keratoconjunctivitis caused by adenovirus type 8. This similarity, as well as the ability of the agent to cause hospital outbreaks, indicates that adenovirus type 19 is a cause of epidemic keratoconjunctivitis. A case of bilateral chronic papillary conjunctivitis that persisted for 16 months following an acute onset was described. Adeno 19 was isolated from the eye of the patient after 12 months of recrudescent or recurrent illness. Chronic adenovirus infection lacking the usual clinical picture of an acute follicular reaction has not hitherto been described. Such cases are probably important because of the obvious danger of continuing the carriage and shedding of infective adeno 19 from one outbreak to another, by presenting subsequently in eye clinics, and providing an unrecognised source of infection to initiate further outbreaks of hospital transmission.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
3/7. Ocular aspects in biotinidase deficiency. Clinical and genetic original studies.There are two distinct forms of multiple carboxylase deficiency. A neonatal onset form is due to deficiency of holocarboxylase-synthetase. A later onset form in which neurological abnormalities are seen as well as those of the skin and hair is due to biotinidase deficiency. It is the purpose of this report to describe a patient with biotinidase deficiency who presents bilateral optic atrophy. The dosage of biotinidase enzyme in the patient's serum and in other members of his family confirms the autosomal recessive transmission of this condition.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
4/7. Conjunctival resection treatment and ultrastructural histopathology of superior limbic keratoconjunctivitis.Four patients with symptomatic superior limbic keratoconjunctivitis underwent resection of the superior bulbar conjunctiva. One of these patients also underwent a tarsal conjunctival resection in the other eye. Three of the patients had previously been treated by various regimens without resolution; the fourth had had no prior treatment. All four patients had immediate and continued relief of the ocular symptoms after the superior bulbar conjunctiva was excised. The patient who underwent tarsal conjunctival resection experienced only short-term relief. We studied the conjunctival tissue by light and transmission electron microscopy. Both techniques revealed abnormalities related to the bulbar conjunctival surface with keratinization of the epithelium, acanthosis, degeneration of the nuclei, and intracellular accumulation of glycogen. Inflammatory cells were minimally present. The tarsal conjunctiva appeared essentially normal.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
5/7. Treatment of microsporidial keratoconjunctivitis with topical fumagillin.Encephalitozoon hellem is a newly described cause of microsporidial keratoconjunctivitis, occurring chiefly in patients with significantly diminished CD4 T-lymphocyte levels. This disorder is symptomatically disabling and generally recalcitrant to topical antimicrobial therapy. Two homosexual men with E. hellem keratoconjunctivitis diagnosed by Gram stain, transmission electron microscopy, and specific indirect immunofluorescent assay were treated with topical fumagillin (Fumidil B). Both patients had marked symptomatic improvement with reduction of clinical findings. Symptoms and signs recurred with temporary discontinuation of the drug. Both patients, however, remained symptom-free on maintenance levels of topical fumagillin with no evidence of toxic side effects.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
6/7. Adenovirus type 8 epidemic keratoconjunctivitis in an eye clinic: risk factors and control.Epidemic keratoconjunctivitis (EKC) due to adenovirus type 8 affected 126 (7%) of 1870 ophthalmology clinic patients during an outbreak. risk factors and mode of transmission were studied by comparing cases (n = 58) and controls (n = 200) for exposure to risk factors. Pneumotonometry (odds ratio [OR], 10.5; 95% confidence interval [CI], 4.0-27.7), multiple clinic visits (OR, 5.9; 95% CI, 3.3-10.6), and contact with an infected physician (OR, 3.3; 95% CI, 1.2-9.0) were significant risk factors for infection. The hands of 3 patients and 3 physicians with EKC were cultured before and after hand washing to assess adenovirus removal; 3 had hand cultures positive for adenovirus after hand washing. In conclusion, this outbreak appeared to be due to inadequate disinfection of instruments, especially pneumotonometers, and finger-to-eye transmission by health care workers. hand washing did not reliably remove adenovirus from contaminated fingers. Gloving for exam of eyes with EKC may help prevent transmission. Ophthalmologists with EKC were a significant risk factor for patients and should be furloughed for the duration of communicability.- - - - - - - - - - ranking = 3keywords = transmission (Clic here for more details about this article) |
7/7. Microsporidial keratoconjunctivitis caused by Septata intestinalis in a patient with acquired immunodeficiency syndrome.PURPOSE: To examine and treat a patient with acquired immunodeficiency syndrome (AIDS) who had mildly hyperemic conjunctiva and epithelial keratopathy in both eyes. methods: The patient underwent conjunctival biopsy. The specimen was examined by transmission electron microscopy. RESULTS: Septata intestinalis was demonstrated to be the cause of keratoconjunctivitis in the patient. The keratoconjunctivitis resolved after three weeks of therapy with topical fumagillin. No organisms were seen on repeat conjunctival biopsy. CONCLUSIONS: Microsporidial keratoconjunctivitis in patients with AIDS can be caused by S. intestinalis. This condition appears to respond to topical fumagillin.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |