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

Fusarium species frequently implicated in human infections include F. solani, F. oxysporum and F. moniliforme. Among immunocompetent patients, tissue breakdown (as caused by trauma, severe burns or foreign body) is the risk factor for fusariosis. Infections include keratitis, onychomycosis and occasionally peritonitis and cellulitis. Treatment is usually successful and requires removal of the foreign body as well as antifungal therapy. Among immunocompromised patients, mainly patients with haematological malignancies, Fusarium spp. are the second most common pathogenic mould. Risk factors for disseminated fusariosis include severe immunosuppression (neutropenia, lymphopenia, graft-versus-host disease, corticosteroids), colonisation, tissue damage, and receipt of a graft from an HLA-mismatched or unrelated donor. Clinical presentation includes refractory fever (> 90%), skin lesions and sino-pulmonary infections ( approximately 75%). Type of skin lesions includes ecthyma-like, target, and multiple subcutaneous nodules. Skin lesions lead to diagnosis in > 50% of patients and precede fungemia by approximately 5 days. In contrast to disseminated aspergillosis, disseminated fusariosis can be diagnosed by blood cultures in 40% of patients. Histopathology reveals hyaline acute-branching septate hyphae similar to those found in aspergillosis. Mortality from fusarial infections in immunocompromised patients ranges from 50% to 80%. Host immune status is the single most important factor predicting outcome. Persistent neutropenia and corticosteroid therapy significantly affect survival. Optimal treatment has not been established. Anecdotal successes have been reported with various agents (high-dose amphotericin B, lipid-based amphotericin B formulations, itraconazole, voriconazole) and with cytokine-stimulated granulocyte transfusions. Preventing fusariosis relies on detection and treatment of cutaneous damage prior to commencing immunosuppression and decreasing environmental exposure to Fusaria (via air and water).
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PMID:Human fusariosis. 1474 3

Infection of the cornea with herpes simplex virus (HSV) can result in a chronic disease called herpetic stromal keratitis (HSK). The disease represents one of the leading causes of infectious blindness in the Western world. Immune-mediated cellular damage is suspected in the pathogenesis of human HSK. The murine model has been pivotal in further establishing HSK as an immunopathological disease. This article reviews understanding of HSK, both in humans and in the mouse model, with an emphasis on possible future therapeutic strategies to counteract this blinding immunoinflammatory disease.
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PMID:Herpetic eye disease: immunopathogenesis and therapeutic measures. 1506 72

The roles free-living amebae and the parasitic protozoa Entamoeba histolytica and Balantidium coli play as agents of waterborne zoonotic diseases are examined. The free-living soil and water amebae Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris are recognized etiologic agents of mostly fatal amebic encephalitides in humans and other animals, with immunocompromised and immunocompetent hosts among the victims. Acanthamoeba spp. are also agents of amebic keratitis. Infection is through the respiratory tract, breaks in the skin, or by uptake of water into the nostrils, with spread to the central nervous system. E. histolytica and B. coli are parasitic protozoa that cause amebic dysentery and balantidiasis, respectively. Both intestinal infections are spread via a fecal-oral route, with cysts as the infective stage. Although the amebic encephalitides can be acquired by contact with water, they are not, strictly speaking, waterborne diseases and are not transmitted to humans from animals. Non-human primates and swine are reservoirs for E. histolytica and B. coli, and the diseases they cause are acquired from cysts, usually in sewage-contaminated water. Amebic dysentery and balantidiasis are examples of zoonotic waterborne infections, though human-to-human transmission can occur. The epidemiology of the diseases is examined, as are diagnostic procedures, anti-microbial interventions, and the influence of globalization, climate change, and technological advances on their spread.
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PMID:Amebae and ciliated protozoa as causal agents of waterborne zoonotic disease. 1556 81

A 7-month-old, male jaguar presented with dyspnea and leukocytosis unresponsive to antibiotic therapy. Radiographs revealed unilateral pulmonary consolidation. An exploratory thoracotomy was performed, and the left lung, which contained a large multilobular mass with extensive fibrosis and numerous caseonecrotic foci, was removed. Microscopically, eosinophilic granulomatous inflammation surrounded broad (4.4-8.3 microm) rarely septate hyphae. A diagnosis of Pythium insidiosum infection was confirmed by immunohistochemistry, immunoblot serology, culture, and polymerase chain reaction. Dyspnea recurred despite treatment, and the animal succumbed 3 weeks after surgery. Necropsy findings indicated that death resulted from occlusion of the right main stem bronchus by a fungal granuloma. The oomycete P. insidiosum typically causes granulomatous disease of the skin or gastrointestinal tract in animals and arteritis, keratitis, or cellulitis in humans. Infection is uncommon in felines, and pulmonary involvement is rare. This report details the first case of P. insidiosum infection in an exotic felid and provides the first description of primary pulmonary pythiosis in any species.
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PMID:Granulomatous pneumonia caused by Pythium insidiosum in a central American jaguar, Panthera onca. 1558 73

Infections with several members of the human herpesviruses are the cause of significant ocular morbidity. Of the human herpesviruses, HSV-1 is the most frequent cause of primary and recurrent eye disease. Despite the availability of effective antiviral treatment, recurrent HSV-1 infection continues to be the leading cause of corneal blindness in industrialized nations. This review recapitulates the current insights in the role of the virus and the intra-corneal T cell response involved in the pathogenesis of human HSV-1-induced keratitis.
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PMID:Human herpes simplex virus keratitis: the pathogenesis revisited. 1562 67

We report a case of intrastromal keratitis in a 42-year-old male with underlying human immunodeficiency virus-1 infection. Numerous microsporidial spores were found from corneal biopsy. Ultrastructural studies of corneal tissues revealed dimorphic sporophorous vesicles containing characteristic spores belonging to Trachipleistophora anthropopthera. Infection could be controlled by penetrating keratoplasty but not by topical fumagillin and systemic albendazole per se. This is the first report of human keratitis caused by this organism.
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PMID:Keratitis caused by Trachipleistophora anthropopthera. 1629 Dec 86

A case of Nocardia asteroides keratitis occurring 3 weeks after laser in situ keratomileusis (LASIK) in a nontraumatized eye is reported. The patient presented with decreased vision, inflammation, and stromal melting of the LASIK flap, discrete infiltrates, and an anterior chamber cellular reaction. Cultures for acid-fast bacteria grew Nocardia asteroides after 5 days. Infection progressed despite treatment with topical antibiotics and eventually required penetrating keratoplasty (PKP). Postoperatively, the patient was placed on moxifloxacin, a fourth-generation flouroquinolone. The patient experienced a recurrence of Nocardia keratitis at the graft-host interface 2 months after the PKP. This eventually resolved with a combination of topical moxifloxacin and imipenem therapy.
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PMID:Nocardia keratitis after laser in situ keratomileusis: clinicopathologic correlation. 1633 76

Infection and inflammation during contact lens wear is often associated with microbial contamination of lenses. Several different types of microbes that colonize lenses can lead to infection and inflammation, but the most common cause of infection (microbial keratitis; MK) remains the Gram-negative bacterium Pseudomonas aeruginosa. P. aeruginosa has a battery of cell-associated and extracellular virulence factors it can use to initiate and maintain infection. Its ability to produce proteases, to either invade or kill corneal cells, and to coordinate expression of virulence factors via quorum-sensing have been shown to be important during MK. Another important factor that contributes to the destruction of the cornea during MK is excessive activation of the host defense system. P. aeruginosa can activate several pathways of the immune system during MK, and activation often involves receptors on the corneal epithelial cells called toll-like receptors (TLRs). These TLRs recognize e.g., lipopolysaccharide or flagella from P. aeruginosa and activate the epithelial cells to produce inflammatory mediators such as cytokines and chemokines. These cytokines or chemokines recruit white blood cells, predominantly polymorphonuclear leukocytes, to the infection in order that they can phagocytose and kill the P. aeruginosa. However, continued recruitment and presence of these polymorphonuclear neutrophils and other white blood cells in the corneal tissue leads to destruction of corneal cells and tissue components. This can ultimately lead to scarring and vision loss.
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PMID:Pseudomonas aeruginosa infection and inflammation during contact lens wear: a review. 1743 10

Free-living amoebae (FLA) occur ubiquitously in many aquatic habitats and humid soils as well as in "artificial" water samples. In addition to their role as pathogens, FLA are known to serve as natural hosts and vehicles of transmission for various intracellular organisms. An otherwise healthy 24-year-old female patient presented with keratitis in her inflamed left eye. She was a contact lens wearer and had no history of corneal trauma. No acanthamoebae could be determined by culture methods. A Vannella strain (called VanAun0) isolated from corneal scrapings showed intracellular aggregating organisms. Within 1-2 days, the host amoebae ruptured, and numerous coccoid organisms (called Kaun1) were released. We succeeded in detecting the mechanisms of infection and intrusion of this eukaryotic organism, growing within the nucleus of the FLA, by light and electron microscopy. It could be shown that the spores at the cell membrane of strain KAun1 resemble Microsporidia and were taken up into the Amoeba by phagocytosis after adhesion of the spores and food cup formation (infective phase). The spores were transported into the cytoplasm of the vannellae in food vacuoles. Phase contrast microscopy revealed early stages of the parasites moving through the cytoplasm into the nucleus of the host amoeba. Electron microscopy showed the proliferation of polymorphic stages within the karyoplasm. The life cycle of these microsporidian-like organisms ended up with a sporogenic phase in which a terminal differentiation took place and numerous spores were released by rupture of the host cell wall. With the rupture of the host amoeba's cell membrane, the cycle started again from the beginning, the released infectious spores being ingested by other host amoebae. In particular, the morphology of the organelles made visible by electron microscopy finally allowed us to classify the endocytobionts as a microsporidan-like organism. Infection of Vannella sp. with the microsporidia-like organism strain KAun1 is a suitable model for studying the host-parasite relations of organisms using their hosts as so-called Trojan horses.
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PMID:Mechanism of intrusion of a microspordian-like organism into the nucleus of host amoebae (Vannella sp.) isolated from a keratitis patient. 1757 85

In the present article, the detection and the development of a parasitic endocytobiont within host amoebae (Acanthamoeba sp.) recently isolated from the contact lens and the inflamed eye of a patient with keratitis is presented. An otherwise healthy 55-year-old female patient presented with keratitis in her inflamed left eye. She was a contact lens wearer and had no history of a corneal trauma. Acanthamoebae as well as other smaller free-living amoebae could be detected from the fluid of the contact lens storage cases by culture methods. A successful therapy could be provided consequently. Two of these Acanthamoeba strains showed intracellular aggregating organisms. Within 2 to 3 days, the host amoebae ruptured, and numerous microorganisms were released. We succeeded in detecting the mechanism of infection and intrusion of this organisms by using light and electron microscopy. Infection with this endocytobiont is a suitable model for studying the host-parasite relations while the parasites use their hosts as so-called Trojan horses (see Barker, Lambert, Brown, Infect Immun 61:3503-3510, 1992).
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PMID:An extraordinary endocytobiont in Acanthamoeba sp. isolated from a patient with keratitis. 1821 Jan 54


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