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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acanthamoeba, a free-living ameba of soil and water, produces the rare infections of granulomatous amebic encephalitis and amebic keratitis. We report a 38-year-old white man with the acquired immunodeficiency syndrome (AIDS) who experienced Acanthamoeba infection that presented as multiple skin nodules without associated encephalitis. Histologic examination revealed necrotizing granulomatous inflammation with numerous amebic organisms that were cultured and identified as Acanthamoeba group 2, probably Acanthamoeba castellani by monoclonal antibodies. Results of in vitro susceptibility testing demonstrated resistance to all six tested drugs. A partial clinical response, however, was obtained with multidrug therapy.
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PMID:Cutaneous Acanthamoeba infection in the acquired immunodeficiency syndrome: response to multidrug therapy. 856 15

Many different infections with protozoan and helminthic parasites are common global health problems. Several protozoa are responsible for opportunistic infections in patients with AIDS. The newly developed drug, albendazole, has a strong activity against many nematode and cestode parasites. In the case of echinococcosis, it reduces the viability of protoscolices and cysts. Its hepatic metabolite, albendazole sulfoxide, is active against the larval cestodes. In the case of neurocysticercosis, administration of either the standard treatment, praziquantel, or the newly developed drug, albendazole, reduces or eliminates tapeworm cysts in 80-90% of patients. Patients with numerous cysts and those in whom neurologic symptoms or intracranial hypertension develops after therapy against cysticerci should receive adjunctive therapy with dexamethasone. Mass chemotherapy with single doses of albendazole or the older drug, mebendazole, is feasible for school-age children to treat the soil-transmitted helminthiases (ascariasis, hook-worm infection, and trichuriasis). The newly developed drug, ivermectin, is more effective against chronic strongyloidiasis than albendazole. It has been used most extensively against river blindness. It greatly reduces the number of microfilariae in the skin and eyes but has no effect on sclerosing keratitis or chorioretinitis. Both drugs are available in the US on a compassionate-use basis from their manufacturers. Field trials show that ivermectin is also effective against lymphatic filariasis and Mansonella ozzardi. Praziquantel is effective against many trematode and cestode infections. It is the drug of choice for schistosomiasis. Albendazole was effective against giardiasis in children in Bangladesh but ineffective in adult travelers returning from tropical areas. It appears to effect symptomatic improvement of intestinal microsporidial infections in patients with AIDS. The newly developed drug, fumagillin, can ameliorate ocular microsporidiosis. The newly developed drug, paromycin, treats cryptosporidiosis. Trimethoprim-sulfamethoxazole treats cyclosporiasis and isosporiasis.
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PMID:Antiparasitic drugs. 860 86

Patients with HIV infection and, above all, patients with full-blown AIDS can get a variety of ocular diseases as well as some cerebral maladies which have an influence on ocular functions. First there are hematogenous opportunistic infections of the retina or the choroid. The cytomegalovirus [CMV] retinitis was found in nearly 20% of all AIDS patients. Without treatment this disease destroys the retina completely, and the involved eye becomes blind. This can be prevented by modern therapeutic strategies in most of the cases. Other infections affecting the retina are toxoplasmosis, systemic varizella zoster or herpes simplex virus infections, syphilis or, seldom, fungal or bacterial pathogens. The choroid mainly can be infested by mycobacteria, cryptococci and pneumocystis carinii. Early detection and treatment of all inflammations are necessary. The anterior eye can be affected by a sicca syndrome and various superficial infections but also noninfectious inflammation. The anterior uvea can be involved in various opportunistic infections of the posterior eye segment. An HIV-associated isolated anterior uveitis has been described in earlier stages of the HIV infection. Treatment of mycobacterial infections with rifabutin can cause an anterior uveitis as well. 1 to 2% of HIV-infected persons suffer from a zoster ophthalmicus with more severe keratitis than it occurs in immunocompetent persons. Last but not least, there are various cerebral affections which can cause visual disturbances. So the optic nerve can be involved in various forms of retinitic or meningoencephalitic processes, of ischemic mechanisms or elevated intracranial pressure. Neuroophthalmological symptoms also include homonymous hemianopsia caused by foci of cerebral toxoplasmosis, progressive multifocal leucencephalopathy or primary intracerebral malignant lymphoma situated in the central neuron of the afferent visual pathway. A variety of oculomotor abnormalities can be caused by a great variety of cerebral disease. Moreover, there are signs of neuroretinal dysfunction in computed perimetry and in color vision or contrast sensitivity testing. Some sight threatening diseases initially can be symptomless for the patient, though they should be treated immediately in order to keep the remaining visual damage small. Thus, regular ophthalmological investigations are necessary in patients with an advanced stage of the immunodeficiency, regardless whether they have ocular complaints or not. Moreover, the patients have to be advised to attend an ophthalmologist immediately, when they notice any kind of visual disturbances or ocular symptoms.
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PMID:[Why are AIDS patients frequently visually impaired?]. 865 Jun 23

A man with acquired immunodeficiency syndrome developed a generalized rash and bilateral dendritic epithelial keratitis without retinitis. Cytologic examination of superficial corneal scrapings showed many megalosyncytial giant cells that were highly characteristic of cytomegalovirus (CMV) infection. Viral cultures yielded CMV from 2 separate specimens obtained by corneal epithelial debridement from both eyes. The slightly elevated, opaque, branching, nonulcerative epitheliopathy recurred after corneal scrapings and persisted despite oral and topical antiviral therapy. Stromal keratouveitis subsequently developed. This case report confirms that CMV can produce corneal involvement and suggests that CMV keratitis may be an emergent complication of acquired immunodeficiency syndrome.
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PMID:Cytomegalovirus keratitis in acquired immunodeficiency syndrome. 866 Jan 74

A 31-year-old man with the acquired immunodeficiency syndrome presented with herpes zoster ophthalmicus on the right. Five days after he began treatment for the zoster pseudodendrites and skin lesions, he developed superficial punctate keratitis, uveitis, and crusting skin lesions in the left eye. After treatment, the ocular lesions resolved in both eyes without incident. The bilateral manifestation of herpes zoster ophthalmicus is a result of the increased severity associated with immunosuppression caused by the human immunodeficiency virus.
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PMID:Presumed bilateral herpes zoster ophthalmicus in an AIDS patient: a case report. 889 77

Inflammatory eye diseases in Aids patients are common. For CMV-retinitis an incidence of up to 45% is reported in the literature. Other retinal diseases such as acute retinal necrosis are less common but are difficult to treat and often follow a disastrous course. Ocular lues may present very different clinical pictures and is the great "imitator" in AIDS patients as well. In toxoplasmosis the typical chorioretinal scars next to the acute inflammatory infiltrates are commonly absent. Infections with candida occur in i.v. drug-addicts in particular. Bacterial corneal ulcers and herpetic keratitis are not more common in HIV-positive patients than in immunocompetent individuals, but the course of the disease is often more severe and prolonged. In patients with low CD4 counts Microsporus can cause painfull keratitis. Mollusca contagiosa are more common in AIDS patients and show the typical lesions, though these are greater in number (commonly more than 20) or in unusual localizations (mucous membrane).
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PMID:[Eye infections in AIDS patients]. 944 3

Manifestations of herpes zoster ophthalmicus (HZO) infection are well known in HIV-seropositive White patients in developed countries, but this association has not been previously noted in African AIDS patients. This paper analyzes 8 cases (3 men and 5 women) 24-40 years of age who were treated at the Eye Department of the University of Nigeria Teaching Hospital, Enugu, for HZO in 1994-97. Of the 6 patients who consented to HIV screening, 4 were HIV-seropositive. One of the HIV-infected patients had been treated for pulmonary tuberculosis a year prior to the present illness, but the remaining 7 were in apparent good health. The patients presented with skin eruptions in the area of distribution of the trigeminal nerve on the affected side of the face and head. Visual acuity was impaired in all 8 cases. The most common ocular findings were lid edema, ptosis, conjunctival infection, corneal anesthesia, keratitis, uveal inflammation, and abnormal pupillary reaction. The severity of presentation was similar in HIV-positive and HIV-negative patients and all improved during follow-up; however, clinical improvement was less rapid or pronounced among the HIV-positive patients. These findings suggest that HZO infection in young Africans should be regarded as a possible indicator of HIV infection.
Int J STD AIDS 1998 Aug
PMID:Herpes zoster ophthalmicus and HIV infection in Nigeria. 970 97

Ophthalmologist with a 4-year history (1993-1997) of practice at the Russian Red Cross Hospital in Addis Ababa (Ethiopia) shares his experience. More than 30,000 patients were examined and treated. Interesting cases are described: cytomegalovirus retinitis in the presence of AIDS, AIDS-associated involvement of the eyes (uveitis, keratitis, Kaposi's sarcoma), herpes zoster involvement of the eyes, phlyctenar keratoconjunctivitis, vernal conjunctivitis, trachoma, diseases of the eyes concomitant with syphilis, a case with Vogt-Koyanagi-Harada. Clinical course and therapy of these diseases under local conditions are described.
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PMID:[Features of the course and treatment of several eye diseases in Eastern Africa]. 972 Apr

Herpetic infection is a common complication among immune suppressed patients following heart, kidney and bone marrow transplantations, in leukemia patients, in AIDS patients, and during treatment with cytotoxic drugs. In the cases described in the literature, oral acyclovir was recommended as a treatment for the acute infection, as well as for prophylaxis. Intravenous acyclovir is not a routine treatment for herpetic keratitis, but is recommended for cases of insufficient clinical response to oral treatment, and defective absorption of acyclovir by the gastrointestinal tract. We present a patient who underwent 4 liver transplantations, was treated regularly with immunosuppressive drugs, and who developed extensive herpetic keratitis. The keratitis was resistant to both topical ointment and oral acyclovir treatment. Recovery was only achieved following the intravenous administration of acyclovir. We recommend intravenous acyclovir treatment at a very early stage for immune suppressed patients with extensive herpes simplex keratitis.
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PMID:Intravenous acyclovir treatment for extensive herpetic keratitis in a liver transplant patient. 975 34

In reviewing the clinical features, diagnostic evaluations and therapies of the most common ocular viral infections we attempt to whet your appetite for attacking the numerous challenges in diagnosis and treatment of viral eye disease. The herpes viruses, HSV, VZV and CMV are the cause of significant ocular morbidity. HSV most commonly affects the cornea producing keratitis that can be recurrent and may lead to corneal clouding and neovascularisation. Manifestations can be purely infectious or immunological and treatment options must be tailored to the underlying pathophysiology. Herpes zoster ophthalmicus, caused by VZV infection of the first branch of the trigeminal nerve, produces a characteristic rash and can progress to keratitis and uveitis. HSV and VZV can cause retinitis in both immunocompetent and immunocompromised individuals. There has been a significant increase in the incidence of CMV retinitis since the beginning of the AIDS epidemic. We review the numerous new treatments, diagnostic tests and treatment strategies which have been developed in response to this potentially blinding retinal infection. Adenovirus produces an epidemic conjunctivitis and epidemic keratoconjunctivitis which are severe and extremely contagious conjunctival infections. HIV, molluscum contagiosum, EBV and rubeola also cause ocular diseases which are described.Copyright 1998 John Wiley & Sons, Ltd.
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PMID:Virus infections of the eye. 1039 8


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