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

Nonherpetic keratitis includes keratitis caused by other viruses, and bacterial, fungal, and acanthamoebic keratitis. Epidemic keratoconjunctivitis, one of the most common corneal manifestations induced by nonherpetic viruses, has usually a good outcome. Conversely, non viral keratitis has more severe complications. Early clinical and microbial diagnosis are the keystones to treat successfully these keratitis. Diagnostic and therapeutic principles are detailed in this review.
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PMID:[Non herpetic keratitis]. 162 Oct 55

Proteolytic enzyme inhibitors are capable of preventing decomposition of the collagen structures of the corneal stroma, and also have a regulating influence on various aspects of the inflammatory process. The content of proteolytic enzymes (alpha 1-antitrypsin and alpha 2-macroglobulin) was studied in the tears and the blood serum of patients with herpes viral keratitis, as well as in the blood serum of rabbits with experimentally-induced ophthalmoherpes. Herpetic keratitis was attended by significant changes in the content of proteolysis inhibitors, as well as in the peripheral blood neutral proteases activity, this presumably serving as a nonspecific blood protective reaction to the inflammation. In the tears of patients suffering from herpetic keratitis the inhibitors are expended for binding activated proteases in the cornea. Local application to rabbits of protein preparations with an inhibitory effect (contrykal, gordox) at the acute period of the experimentally-induced ophthalmoherpes produced a marked antiphlogistic effect.
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PMID:Antiproteases in herpetic keratitis. 245 13

Unlike Corynebacterium diphtheriae and Propionibacterium acnes, the pleomorphic gram-positive rods known as diphtheroids are generally regarded as nonpathogenic contaminants of the human external eye. We reviewed five years of microbiology records at Wills Eye Hospital and studied a series of eight cases of apparently infectious keratitis associated with heavy growth of diphtheroids on cultures of ulcer scrapings. All of these cases included indolent ulcers that occurred almost exclusively in elderly patients (mean age, 72 years; range, 11 to 92 years). All patients had preexisting ocular conditions that compromised the corneal surface such as exposed corneal sutures, eyelid surgery, aphakic extended wear contact lenses, viral keratitis, and diabetes mellitus. No other pathogens were isolated. All infections responded well to antibiotic therapy with all organisms sensitive to cefazolin and all but one sensitive to gentamicin.
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PMID:Diphtheroids as ocular pathogens. 277 33

After inoculation of herpes simplex virus (HSV) on the snout of the mouse, spread to the eye occurs via neural pathways. The keratitis which ensued was clinically atypical for a pure herpetic keratitis, leading to a search for other causative agents. Preliminary data suggests that bacteriological super-infection of the viral keratitis occurs frequently, producing a unique experimental model.
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PMID:Preliminary data suggest a role for bacterial superinfection of a viral keratitis after zosteriform spread of herpes simplex virus to the eye of the mouse. 341 59

The relative efficacy of 5-methoxymethyldeoxyuridine (MMUdR), adenine arabinoside (Ara-A), 5-iododeoxyuridine (IUdR) and the combination of MMUdR and Ara-A in the treatment of experimental herpes simplex keratitis was investigated in rabbits. Treatment was initiated either at 4 or 24 h post virus inoculation. The parameter used to evaluate effectiveness was lesion size. Each eye was graded daily for the first 5 days and on alternate days thereafter to day 11. At concentrations of 2 or 5% both MMUdR and Ara-A were found to have potent antikeratitis activity. At 5% concentration, Ara-A provided essentially the same protection against herpes keratitis as 0.1% IUdR, while MMUdR was slightly less effective. The simultaneous application of 2% MMUdR and 2% Ara-A in combination was more effective than 5% MMUdR alone and was effective as 5% Ara-A or 0.1% IUdR in controlling the viral keratitis.
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PMID:Comparative efficacy of 5-methoxymethyl-2'-deoxyuridine, 9 beta-D-arabinofuranosyladenine and 5-iodo-2'-deoxyuridine in the treatment of experimental herpes simplex keratitis. 735 40

The authors sought to determine whether adenovirus could infect human corneal epithelium in vivo. They reviewed the medical records of six patients with adenovirus-positive viral corneal cultures who were examined at the Bascom Palmer Eye Institute between March 21, 1986, and December 31, 1992. The six patients with adenovirus-positive viral corneal cultures included one patient with dendritic epithelial keratitis, one with geographic epithelial ulceration, three with both geographic ulceration and contiguous dendrites, and one with heaped-up corneal epithelium but no ulceration. Four patients had rose bengal solution applied to their ocular surface, and in all four patients rose bengal uptake was seen at the epithelial edges of the dendrite or geographic ulceration in a manner characteristic of herpes simplex viral keratitis. Serotype determination of the isolates showed adenovirus type 3 (one patient), type 8 (three patients), type 19 (one patient), and indeterminate (one patient). Results of monoclonal antibody staining of cultures against herpes simplex virus (types 1 and 2) antigens was negative for all six cases. Adenovirus epithelial keratitis may result from infection of human corneal epithelium by the virus and rarely may mimic infection of corneal epithelium by herpes simplex virus.
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PMID:Adenovirus epithelial keratitis. 774

Herpes simplex keratitis s a significant cause of blindness worldwide. Nitric oxide (NO) has been shown to play a role in non-specific defence mechanisms and cell signalling in bacterial and parasitic infections. We investigated if Herpes simplex virus (HSV) isolated from keratitis could induce NO production. Human corneal epithelial cells were infected with high (multiplicity of infection; MOI 0.4) and low (MOI 0.04) HSV-1 and HSV-2 concentrations. Culture supernatants were collected at 1 h, 4 h, 8 h, 12 h and 24 h postchallenge. Samples were prepared by removal of proteins by ultrafiltration. Production of NO was measured using nitrite and nitrate assays. Herpes simplex virus-1 downregulated the production of NO, while HSV-2 upregulated NO production. Downregulation of NO could be a survival strategy against the cytotoxic action of NO, to eliminate infected cells. Upregulation of NO production may be associated with the presence of glycoproteins on the viral coat, which have been shown to induce NO in other disease conditions. Further studies are required to confirm the role of NO in viral keratitis.
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PMID:The differential regulation of nitric oxide by Herpes simplex virus-1 and -2 in a corneal epithelial cell line. 1098 95

An 82-year-old healthy man with unilateral chronic stromal keratitis, initially diagnosed to have viral keratitis and refractory to medical therapy, showed numerous oval, microsporidial organisms, measuring 4-5 m in length in the corneal biopsy. Penetrating keratoplasty, followed by treatment with systemic albendazole and topical propamidine isethionate resulted in resolution of the infection. Electron microscopy of the keratoplasty specimen demonstrated sporoblasts with diplokaryotic nuclei and multiple coils of the filament. The light and electron microscopic features were consistent with microsporidial keratitis.
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PMID:Chronic microsporidial stromal keratitis in an immunocompetent, non-contact lens wearer. 1597 69

We report the case of a 29-year-old Jamaican patient who presented with severe pain, redness, and swelling of both eyes. She was a regular soft contact lens wearer who did not maintain standard lens care. She was treated for a possible microbial/viral keratitis using topical ciprofloxacin drops, topical acyclovir ointment, and topical atropine drops. The response was inadequate, and scrapings from her cornea, contact lens cases, and both lenses revealed Acanthamoeba on microscopy, which was shown to be Acanthamoeba polyphaga using polymerase chain reaction. She was treated using chlorhexidine 0.02% hourly, ciprofloxacin every 4 hours, and atropine 1% every 12 hours, along with oral ketoconazole 200 mg twice daily with a dramatic response. However, she subsequently suffered slow corneal epithelial regrowth with severe scarring, vascularization, and cortical lens opacification and was referred for penetrating keratoplasty and cataract surgery. This is the first case of severe keratitis caused by Acanthamoeba to be reported from Jamaica and demonstrates that this emerging pathogen can be a cause of severe keratitis in the tropics.
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PMID:Acanthamoeba infection as a cause of severe keratitis in a soft contact lens wearer in Jamaica. 1601 41

For the purpose of this symposium, the term "keratitis" implies suppurative nonviral and viral keratitis. Corneal ulcers have been described in ancient literature. But even today, despite the availability of a wide range of newer antimicrobials and new diagnostic techniques, infective keratitis continues to pose a diagnostic and therapeutic challenge. This article focuses on the key diagnostic clinical features of the most common organisms causing infective keratitis - bacteria, fungi, viruses, nocardia and acanthamoeba - in India. While the clinical features in some cases are fairly straightforward, most cases challenge the clinician. We describe the salient clinical features which can help arrive at a diagnosis to begin appropriate treatment immediately, prior to the laboratory report.
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PMID:Distinguishing infective versus noninfective keratitis. 1841 20


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