Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Branhamella catarrhalis was formerly regarded as a common, essentially harmless inhabitant of the pharynx. This misapprehension was caused, in part, by confusion with another pharyngeal resident, Neisseria cinerea. The two organisms can now be differentiated by the positive reactions of B. catarrhalis in tests for nitrate reduction and hydrolysis of tributyrin and DNase. B. catarrhalis is currently recognized as the third most frequent cause of acute otitis media and acute sinusitis in young children. It often causes acute exacerbations of chronic bronchopulmonary disease in older or immunocompromised adults and is incriminated occasionally in meningitis, endocarditis, bacteremia, conjunctivitis, keratitis, and urogenital infections. Virulence-associated factors, such as pili, capsules, outer membrane vesicles, iron acquisition proteins, histamine-synthesizing ability, resistance to the bactericidal action of normal human serum, and binding to the C1q complement component, have been identified in some strains. beta-Lactamase producing strains, first detected in 1976, have risen to approximately 75% worldwide. Thus far, however, practically all American strains of B. catarrhalis remain susceptible to alternative antibiotics. A possible selective advantage of recent isolates is their reportedly heightened tendency for adherence to oropharyngeal cells from patients with chronic bronchopulmonary disease.
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PMID:Branhamella catarrhalis: an organism gaining respect as a pathogen. 212 28

Five hundred forty-seven reports of adverse reactions to timolol maleate received by the National Registry for Drug-induced Ocular Side Effects during an eleven-month period were reviewed. Approximately half the reports concerned systemic reactions affecting the cardiac, pulmonary, central nervous, gastrointestinal, and dermatologic systems. Most serious were depression, anxiety, and confusion; bradycardia and arrhythmias; and pulmonary airway obstruction. Half of the ocular side effects concerned external ocular disease, of which superficial punctate keratitis and corneal anesthesia were the most remarkable. Ten percent of the reports described a visual disturbance which, in many cases, was not associated with refractive error.
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PMID:Adverse reactions from timolol administration. 740 90

Acanthamoeba organisms are a well-known, although rare, cause of central nervous system infection in immunodeficient hosts, including those with the acquired immunodeficiency syndrome. Extracerebral acanthamebiasis, with the exception of contact lens-associated keratitis, is reported but little emphasized in the literature. We describe two patients with the acquired immunodeficiency syndrome in whom skin lesions were the primary manifestations of Acanthamoeba infection. Central nervous system disease was proved in one patient and suspected, but unproved, in the other. The skin lesions exhibited an intact epidermis with suppurative inflammation of the subcutis, associated with numerous amebic cysts and trophozoites. The amebic cyst walls stained with periodic acid-Schiff and Gomori's methenamine-silver stains, creating confusion with Blastomyces dermatitidis yeast in one instance. Immunofluorescence studies and culture identified the organisms as an Acanthamoeba species. Preliminary studies in one of the cases suggested a previously undescribed Acanthamoeba species as the etiologic agent. Our experience emphasizes that skin lesions may be the presenting sign of disseminated Acanthamoeba infection in patients with the acquired immunodeficiency syndrome.
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PMID:Acanthamoeba infection presenting as skin lesions in patients with the acquired immunodeficiency syndrome. 821 28

Down syndrome (DS) is the most common cause of mental retardation in North America, yet little information is available on the natural history of DS in adults. We report on significant medical problems of adults with DS (DS adults) residing in a British Columbia provincial residential center, Woodlands, over the 12-year period from 1981 through 1992. Prospective, yearly health care reviews on 38 DS adults are summarized according to age. Group 1 consists of 18 middle-aged DS adults less than 50 years old, and group 2 comprises 20 elderly DS adults 50 years and older. Significant health problems in all DS adults include untreated congenital heart anomalies (15. 8%), acquired cardiac disease (15.8%), pulmonary hypertension (7.8%), recurrent respiratory infections/aspiration leading to chronic pulmonary interstitial changes (30%), complications from presenile dementia/Alzheimer-type disease (42%), adult-onset epilepsy (36.8%), osteoarthritic degeneration of the spine (31.6%), osteoporosis with resultant fractures of the long bones (55%) or vertebral bodies (30%), and untreated atlantooccipital instability (7.9%). Acquired sensory deficits are significant problems including loss of vision due to early onset of adult cataracts (50%), recurrent keratitis (21%) or keratoconus (15.8%), and significant hearing loss (25%). Behavioral problems (50%), loss of cognitive abilities, and onset of symptoms of Alzheimer disease (group 1: 5.5%; group 2: 75%) pose ongoing challenges for care. In conclusion, the quality of life for adults with DS can be improved by routine, systematic health care screening to identify treatable diseases that may be missed because of poor communication or confusion due to Alzheimer disease.
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PMID:Health care concerns and guidelines for adults with Down syndrome. 1055 65

A 48-year-old man had simultaneous bilateral photorefractive keratectomy (PRK). The surgeon who performed the PRK did not see the patient in follow-up, and there was confusion regarding the comanaging doctor. Therefore, the patient was not examined immediately postoperatively. Several days later, he was hospitalized for an unrelated, painful orthopedic problem and heavily sedated. Seven days after the PRK, an ophthalmologist was consulted for ocular irritation and discharge. Examination showed bilateral, purulent conjunctivitis and severe infectious keratitis in the left eye. The patient was treated with periocular and topical antibiotics. Corneal cultures yielded Staphylococcus aureus. The keratitis resolved slowly, leaving the patient with hand motion visual acuity. A corneal transplant and cataract extraction was performed 15 months later, resulting in a best corrected visual acuity of 20/400 because of glaucomatous optic nerve damage. Severe infectious keratitis may occur after PRK. Poor communication between the surgeon, comanaging doctor, and patient may result in treatment delay.
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PMID:Infectious keratitis after photorefractive keratectomy in a comanaged setting. 1064 60

Microsporidia are a diverse group of obligate, intracellular, eukaryotic, spore-forming parasites. Traditionally, these were considered as protozoans but recently have been reclassified as fungi. Microsporidia behave as opportunistic pathogens causing systemic infections. In the eye, Microsporidia cause keratoconjunctivitis, corneal stromal keratitis, scleritis, and endophthalmitis. This review shares our experiences with anterior segment infections caused by this pathogen. Keratoconjunctivitis is a common form of ocular infection caused by the parasite. Although early reports described it as occurring only in immunosuppressed individuals, it can also occur in immunocompetent individuals. The disease shows a seasonal pattern with a peak incidence during the rainy season. Although several drugs have been considered, our experience suggests that keratoconjunctivitis is a self-limiting disease. In contrast to keratoconjunctivitis, stromal keratitis is an ill-defined disease. We collected 30 cases and analyzed the various aspects of this disease. Stromal keratitis is characterized by a slowly progressive course. The corneal picture resembles herpes simplex virus stromal keratitis or fungal keratitis cases, and is characterized by deep stromal infiltrates with overlying and surrounding stromal edema and keratic precipitates. The diagnosis of Microsporidia infection is confirmed by a microscopic examination of smears from patients with ulcerative keratitis or by a histopathological examination of corneal tissues. Definitive genus identification requires the examination of specimens by electron microscopy or by molecular methods. In the absence of a definitive medical treatment, nearly all patients require surgical treatment. The confusion regarding Microsporidia is not only limited to their classification but also extends to various aspects of the corneal disease caused by them.
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PMID:Microsporidia infection of the cornea--a unique and challenging disease. 2410 31

We describe the clinical outcomes of two contrasting cases of fungal keratitis due to Paecilomyces spp. The first case involving a 58-year-old woman was complicated by an initial laboratory misidentification as Penicillium and consequently a delay in treatment with an optimised antifungal regimen. The patient had a protracted clinical course that required a total of four penetrating keratoplasties. However, an accurate diagnosis was promptly made in the second case, a 46-year-old woman, which resulted in a satisfactory outcome after penetrating keratoplasty. Our principal aim was to highlight a diagnostic challenge relating to the accurate microbial identification of Paecilomyces spp. This can be difficult given its morphological similarity to Pencillium, and confusion over the two genera has resulted in misdiagnoses reported previously. Our report aims to raise awareness of this potential laboratory misidentification, which can affect clinical decision-making in guiding antimicrobial therapy.
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PMID:A masquerader? Paecilomyces must be distinguished from Penicillium in fungal keratitis: a report of two contrasting cases. 2628 7

To demonstrate the identification of corneal diseases using a novel deep learning algorithm. A novel hierarchical deep learning network, which is composed of a family of multi-task multi-label learning classifiers representing different levels of eye diseases derived from a predefined hierarchical eye disease taxonomy was designed. Next, we proposed a multi-level eye disease-guided loss function to learn the fine-grained variability of eye diseases features. The proposed algorithm was trained end-to-end directly using 5,325 ocular surface images from a retrospective dataset. Finally, the algorithm's performance was tested against 10 ophthalmologists in a prospective clinic-based dataset with 510 outpatients newly enrolled with diseases of infectious keratitis, non-infectious keratitis, corneal dystrophy or degeneration, and corneal neoplasm. The area under the ROC curve of the algorithm for each corneal disease type was over 0.910 and in general it had sensitivity and specificity similar to or better than the average values of all ophthalmologists. Confusion matrices revealed similarities in misclassification between human experts and the algorithm. In addition, our algorithm outperformed over all four previous reported methods in identified corneal diseases. The proposed algorithm may be useful for computer-assisted corneal disease diagnosis.
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PMID:Deep learning for identifying corneal diseases from ocular surface slit-lamp photographs. 3308 30