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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of enteroviruses in certain specific disease--cardiac disease, nephritis, diabetes, and hemorrhagic conjunctivitis--is examined. It has now been well documented that Coxsackievirus B (types CB1 through CB5 but not CB6) is the main pathogen involved in various clinical forms of viral heart disease. Coxsackievirus A (CA4 and CA16) and echovirus (types 9 and 22) may also be associated with viral heart disease. In regard to the etiologic role of enteroviruses in nephritis, pancreatitis, and diabetes, again CBV, especially CB3 and CB4, has been suspected, but the data are controversial and further studies are needed. Hemorrhagic conjunctivitis, a newly observed clinical entity, is caused by enterovirus 70. It has spread to four continents (not including the Americas) in a pandemic fashion since 1969 and is now one of the common eye infections in these areas. The virus has some neurovirulence, and motor paralysis is known to occur as a complication; hence it should be carefully watched in the future.
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PMID:Enteroviruses other than poliovirus. 19 2

Ocular involvement in Yersinia enterocolitica infection presenting as a Parinaud's oculoglandular syndrome occurred in a 77-year-old woman with diabetes. Yersinia enterocolitica was recovered from cultures of the conjunctiva, cornea, fistula tract, and blood. The patient responded to parenteral and topical administration of gentamicin and a corneal transplant. While hospitalized, she developed peritonsillar inflammation and enlarged, tender lymph nodes in the preauricular, submaxillary, and submandibular areas. The combination of the unilateral granulomatous conjunctivitis and enlarged regional lymph nodes was consistent with the diagnosis of Parinaud's oculoglandular syndrome. Yersinia enterocolitica may be another cause of Parinaud's oculoglandular syndrome.
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PMID:Ocular involvement in Yersinia enterocolitica infection presenting as Parinaud's oculoglandular syndrome. 83 62

The serotypes and antibiotic sensitivity patterns of Streptococcus pneumoniae infections were studied in 208 patients. Male to female ratio was 3 to 1. The main underlying diseases were cardiopulmonary disease (53%), sickle cell disease (13%), diabetes mellitus (11%) and malignancies (11%). The commonest infections were conjunctivitis, bronchopulmonary infections and otitis media. Serotypes 6 and 19 were the most common, especially in children, constituting 66% of the isolates. All the isolates were sensitive to penicillin, ampicillin and vancomycin, but 65% were resistant to cotrimoxazole. Penicillin, therefore, remains the best antimicrobial agent for treatment. All the serotypes are represented in the polyvalent pneumococcal vaccine available in the country; therefore some benefit can be expected from vaccination especially in the high risk patients.
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PMID:Pneumococcal infections in eastern Saudi Arabia: serotypes and antibiotic sensitivity patterns. 318 10

A case of sulindac-induced toxic epidermal necrolysis (TEN) is described; the etiology, symptoms, and treatment of TEN are reviewed; and sulindac's pharmacokinetic characteristics and other adverse effects are discussed. A 62-year-old black woman was given a prescription for sulindac 150 mg twice daily to relieve pain associated with degenerative joint disease. She also had a nine-year history of type II diabetes mellitus that was being managed with tolbutamide 500 mg once daily. After two weeks of sulindac therapy she developed a rash that spread over her entire body. Sulindac therapy was discontinued, and one day later the patient was admitted to the hospital with a temperature of 104.6 degrees F, conjunctivitis, and an erythematous macular rash over 60% of her body. Initially, therapy included prednisone 160 mg orally every day, applications of silver sulfadiazine cream four times daily for two days, and methylcellulose 0.5% ophthalmic solution (two drops four times daily) for the conjunctivitis. She also received intravenous hydration. By the fifth hospital day the patient's skin lesions and conjunctivitis had improved to the point that the prednisone dosage was tapered to 120 mg, then to 80 mg, and then to nothing over the following three days. Her diabetes was managed by short-term treatment with NPH insulin; however, before discharge, tolbutamide therapy was reinstituted, and insulin was discontinued. At follow-up four weeks after discharge, the patient's skin was largely clear. TEN has multiple etiologies, but the basic mechanism of injury is believed to be an immunological reaction directed at the basal cell layer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sulindac-induced toxic epidermal necrolysis. 323 97

The clinical and diagnostic features of 29 adult patients with H. influenzae septic arthritis are reviewed. Twelve men and 17 women ranging in age from 22 to 82 years developed the infection. H. influenzae septic arthritis is an acute, febrile disease with a mean duration of symptoms before diagnosis of 4 days. Fifteen patients had monoarticular arthritis, 6 with an infected knee. Polyarticular involvement, with a range of 2 to 9 joints, was diagnosed in 14 patients. Nineteen patients had concurrent extraarticular sites of infection, including meningitis, pneumonia, pharyngitis, sinusitis, conjunctivitis, and cellulitis. Twenty-two of 29 patients had predisposing factors for infection, including ethanolism, trauma, rheumatoid arthritis, systemic lupus erythematosus, diabetes mellitus, splenectomy, multiple myeloma, lymphoma, gout, and acquired common variable hypogammaglobulinemia. Characteristic synovial fluid findings included purulent, greenish fluid, elevated WBC count, and gram-negative pleomorphic microorganisms. Treatment for these patients included antibiotic therapy, most often ampicillin and chloramphenicol, and joint drainage by repeated arthrocentesis or arthrotomy. A favorable outcome was reported in 25 of 29 patients. Hemophilus influenzae septic arthritis should be suspected in adults who are immunocompromised and have a concurrent extraarticular source of infection.
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PMID:Hemophilus influenzae septic arthritis in adults. A report of four cases and a review of the literature. 348 37

An alcoholic man with uncontrolled diabetes mellitus had right conjunctivitis, facial numbness, and periorbital edema progressing to bilateral visual loss, and left ptosis in association with a large necrotic palatal ulcer due to zygomycosis. The infection progressed to bilateral retinal vein engorgement; left-sided ophthalmoplegia, fixed dilated pupil, and absent corneal reflex; and right-sided ophthalmoplegia, ptosis, and facial nerve paralysis. Work-up revealed disease of both ethmoid sinuses and the right maxillary sinus, with bilateral thromboses of the cavernous sinuses. An aggressive combined therapeutic attack (three Caldwell-Luc procedures, exploration of orbit walls, control of diabetes, systemic and local amphotericin therapy) led to survival with a three-year follow-up thus far.
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PMID:Survival in cerebro-rhino-orbital zygomycosis and cavernous sinus thrombosis with combined therapy. 370 11

In the ophthalmological field, it is not always easy to adopt a primary prevention. Much more useful would be a secondary prevention program towards the affections at birth or those later developed that, if diagnosed and treated early, grant a normal visual development. Differentiated prevention can be carried out, according to various ages: at the tender age congenital glaucoma and cataract, strabism, ametropia, anisometropia (possible cause of amblyopia) have to be considered; in the adult-senile age must be prevented damages due to hypertension, diabetes, thrombosis, as well as cataract, glaucoma, uveitis, kerato-conjunctivitis and retinal detachment.
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PMID:Epidemiological aspects, development and management of prevention in ophthalmology in relation to different ages. 747 19

The case is recounted of a child who was admitted to hospitals several times over a period of 8 years on account of fictitious illnesses invented by his mother. The first occurred when he was 3.5 years old in January 1984. His mother, a nurse, gave a history of intermittent fever for 3 months, loss of appetite and weight. He had been treated with ampicillin, chloramphenicol, and procaine penicillin. No abnormality was detected and his weight at 15.5 kg was appropriate for his age. No fever was recorded throughout 2 weeks in hospital, but he was given chloroquine for possible malaria and then discharged. At follow-up 6 months later, the mother complained of his wheezing. On examination he was normal and had gained 3.8 kg since discharge. The possibility of vernal conjunctivitis plus asthma was entertained and he was then placed on ketotiphen prophylaxis. There was an uneventful follow-up for 6 months. 5 years later in March 1990, his mother related that he had been treated from 22 January 1988 to 21 November 1989 for tuberculosis with streptomycin, isoniazid, rifampicin, and ethambutol. He was also treated with digoxin and Esidrex-K for suspected rheumatic carditis, after which at the University Teaching Hospital, Enugu, he was investigated from 11 April 1989 to 10 August 1989 and found to be normal. One year later in August 1991 she went to one of the authors complaining about polydypsia, polyphagia, and polyuria. Examination had revealed nothing of note. A clinical assessment for diabetes mellitus found the urine specific gravity persistently at 1.010. He was therefore put on carbamazepine (Tegretol) 100 mg t.i.d. After review by a pediatric nephrologist, the child was declared normal. During this visit, the mother and child were interviewed separately. He believed he was ill because his mother said so. A diagnosis of Munchausen syndrome by proxy was made. The mother was referred back to her doctor to arrange for psychiatric care. In Munchausen syndrome, patients fabricate a variety of symptoms and evidence of illness that have no organic basis. Munchausen syndrome by proxy is a form of child abuse, difficult to diagnose, that could result in death. It is more prevalent in affluent countries with sophisticated medical facilities. Its rarity in developing countries may contribute to the difficulty of detection.
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PMID:Munchausen syndrome by proxy: an experience from Nigeria. 750 55

Ocular signs and symptoms provide clinical clues to many of the more common metabolic and nutritional disorders seen in older adults. Diabetes mellitus can affect all parts of the eye and orbit. Complications include refractive visual loss, macular edema, retinopathy, increased risk of fungal infection, and diplopia. In patients with gout, urate crystals may precipitate in the eye and cause conjunctivitis, uveitis, or scleritis. Other problems are seen with Wilson's disease, hyperlipidemia, and albinism. Nutritional disorders usually arise from malabsorption, gastrointestinal surgery, and alcohol abuse. Deficiencies in vitamins A, B1 (thiamine), B12, and C may be manifest in the eye.
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PMID:Clues in the eye: ocular signs of metabolic and nutritional disorders. 760 60

Three men and one woman (mean age 52 years) were admitted to hospital for septicemia (2 cases), sudden partial loss of visual acuity (1 case) and suspected conjunctivitis (1 case). Three of the patients showed risk factors (diabetes, alcohol intoxication, immunosuppression). Panophthalmitis (affecting all tunics of the eye) was apparent from the initial examination in all 4 cases (2 bilateral and 2 unilateral). Ocular involvement was associated with endocarditis and meningitis (pneumococcus) in 1 case, with nocardiosis (pulmonary, cerebral and nodal) in 1 case, and with septicemia with bacterial arthritis (Escherichia coli, streptococcus A) in 2 cases. Hemocultures were positive in 3/4 cases. The micro-organism was also detected in the joint (n = 2), urine (n = 1) and cerebrospinal fluid (n = 1), during pulmonary transparietal puncture (n = 1) and in intraocular biopsy tissue (n = 1). All patients received appropriate antibiotic therapy intravenously and intraocularly. The infection was cured in all cases, but with severe functional sequelae: blindness in 2 cases, and unilateral enucleation in the other 2 cases.
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PMID:[Hematogenic bacterial endophthalmitis. A rare infection with very poor functional prognosis]. 879 96


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