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

An experimental model of staphylococcal keratitis in guinea pigs was devised that is suitable for quantitative evaluation of therapy. The growth curve in the cornea of a virulent strain of Staphylococcus aureus was determined. The organism multiplied rapidly, reached a peak in about 12 hours, and began to decline in numbers after three days. Infections were relatively resistant to therapy begun 24 hours after infection was established. Treatment started earlier when fewer bacteria were present was more effective than treatment begun later. Treatment begun at the time of infection, which might be considered prophylaxis, was highly effective. When treatment was begun eight hours after infection, tobramycin sulfate and gentamicin sulfate solutions administered topically in doses of 20 mg/ml were more effective than topical bacitracin, erythromycin, clindamycin phosphate, or a solution containing polymyxin B sulfate, neomycin sulfate, and gramicidin. Bacitracin and erythromycin ointments were ineffective.
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PMID:Staphylococcal keratitis. Experimental model in guinea pigs. 71 6

Infections caused by small, free-living amebas are still unfamiliar to many clinicians, pathologists, and laboratorians. As of 31 July 1989, more than 140 cases of primary amebic meningoencephalitis caused by Naegleria fowleri and more than 40 cases of granulomatous amebic encephalitis caused by Acanthamoeba species (including two cases in patients with AIDS) and possibly by other free-living amebas had occurred worldwide. The recent increase in acanthamoeba keratitis (more than 200 cases), especially in contact lens wearers, has generated new interest in this group of amebas. Effective treatment is still lacking. Risk factors, clinical manifestations, and laboratory parameters helpful in the recognition of infections of the central nervous system (i.e., granulomatous amebic encephalitis and primary amebic meningoencephalitis) and acanthamoeba keratitis are reviewed.
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PMID:Naegleria and Acanthamoeba infections: review. 219 54

The paper analyses results after treatment of 30 patients with herpetic keratitis by means of a specific antiherpetic immunoglobulin manufactured at the Sverdlovsk Research Institute of Virus Infections. As compared with traditional treatment, the terms of clinical recovery and the number of bed-days reduced. The preparation can be used in a complex treatment of patients with a herpetic disease.
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PMID:[The use of an immunoglobulin in the comprehensive treatment of ophthalmic herpes]. 225 81

We have reported 7 new cases of Bipolaris infection and 2 of Exserohilum infection, which demonstrate the capability of these 2 genera to cause invasive as well as "allergic" disease. As noted previously, it is likely that all of the cases of "Helminthosporium" and Drechslera infections reported in the literature were caused by Bipolaris or Exserohilum. Infections due to these 2 genera are probably more common than previously recognized. They should be included in the differential diagnosis of central nervous system and disseminated fungal disease, sinusitis, keratitis, peritonitis associated with continuous ambulatory peritoneal dialysis, and allergic bronchopulmonary disease. These various entities have distinct histopathologic characteristics. With disseminated disease in the immunocompromised patient, the most frequent findings are acute inflammation with prominent vascular invasion, thrombosis, and infarction. In contrast, granulomatous inflammation and leukocytoclastic vasculitis are seen in meningoencephalitis caused by these fungi. The histologic features of allergic bronchopulmonary disease and sinusitis are similar. A chronic inflammatory infiltrate of lymphocytes, plasma cells and eosinophils within edematous granulation tissue is found in addition to squamous metaplasia and thickening of the basement membrane. Infections caused by Bipolaris/Exserohilum and Aspergillus show many clinical and pathologic similarities despite the lack of taxonomic relationship between these fungi. Both cause disseminated disease in immunocompromised patients that is characterized by tissue necrosis and vascular invasion. Both cause central nervous system disease, osteomyelitis, and sinusitis and are associated with allergic bronchopulmonary disease. Sinusitis, the most common form of disease caused by Bipolaris and Exserohilum, occurs in otherwise healthy patients with nasal polyposis and allergic rhinitis. Although pathologic evidence of bone invasion may not be found, there frequently is radiographic evidence of invasive disease. Most patients who are treated initially with surgical debridement and amphotericin B have apparently been cured. However, longer follow-up will be necessary in these patients. Amphotericin B appears to be the treatment of choice for invasive infections caused by Bipolaris/Exserohilum species. Ketoconazole and other imidazole derivatives may also be effective in certain of the disease entities caused by these black moulds; however, their role has yet to be defined.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Phaeohyphomycosis caused by the fungal genera Bipolaris and Exserohilum. A report of 9 cases and review of the literature. 352 12

The prevalence, intensity and clinical manifestations of onchocerciasis were investigated in three village communities along the Bahr El Arab and its tributaries in Southern Darfur, Western Sudan. Onchocerca volvulus has not been reported from this region before. Over 300 people were examined and the selection of patients was aimed at obtaining a cross-sectional view of the disease at all ages and in both sexes. Prevalence rates were high (67.5%, 28.6% and 32% in Titribi, Radom and Kafia Kingi, respectively). The intensity of infection in young adults was generally about 30 mf/mg, but ranged up to 100 mf/mg. Infections were detected in subjects as young as two years old; about one quarter of those sampled in Titribi had nodules, mostly in the pelvic region. Clinical signs of acute and chronic dermal changes were especially marked in Titribi. This village was located closest to the breeding sites, which appear in the rainy season only. More than a third of those samples had severe pruritus and showed many self-inflicted excoriations. Both anterior and posterior eye segment changes were detected in each community, and cases of onchocercal blindness were attributed to sclerosing keratitis and to optic and chorioretinal atrophy. One case typical of intensely localized disease was seen, where the affliction was unilateral and severe with oedema and pigment changes, but very few microfilariae present. Onchocerciasis appears to be well established in this region and has apparently caused abandonment of some settlements in recent years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Onchocerciasis in Sudan: the Southern Darfur focus. 360 40

One hundred twenty-five cases of disease due to rapidly growing mycobacteria were observed over a four-year period. Cutaneous infections accounted for 74 cases (59%). Of these, 40 followed surgical procedures (especially augmentation mammaplasty or median sternotomy), and 34 were due to accidental penetrating trauma. Among the 24 patients with pulmonary disease, the mean age was approximately 60 years, the majority of patients (63%) were women, and most had unilateral noncavitary disease. Other infections included disseminated disease with multiple nodular skin lesions and positive blood cultures, cervical lymphadenitis, keratitis, and endocarditis associated with a prosthetic valve. Infected tissues showed mixed acute and granulomatous inflammation; acid-fast bacilli, when present, occurred in extracellular clumps within microabscesses. Mycobacterium fortuitum and Mycobacterium chelonei were encountered with approximately equal frequency; 80% of isolates of M. chelonei were subspecies abscessus, and 83% of isolates of M. fortuitum were biovariant fortuitum. The outcome in these infections was generally good, although 9% of the patients, including all those with endocarditis, died. Infections due to M. fortuitum and M. chelonei are probably markedly under-diagnosed, and these organisms are capable of causing a wide spectrum of clinical disease.
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PMID:Spectrum of disease due to rapidly growing mycobacteria. 635 28

The eye is relatively impermeable to micro-organisms and other environmental elements. However, if corneal integrity is breached by trauma, a sight-threatening bacterial infection can result. Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pneumoniae are the most common bacterial pathogens associated with infection of compromised corneas. Bacterial enzymes and toxins, as well as factors associated with the host immune response, can lead to tissue destruction during corneal infection. For successful therapy, an antibacterial agent must be active against the pathogen and must be able to overcome the permeability barrier of the cornea. Topical application of antibacterial agents adequately delivers drugs to the cornea and aqueous humour. However, drug concentrations at the site of infection are not always sufficient to rapidly kill infective organisms. Infections with antibiotic-resistant strains present an even greater therapeutic challenge. In addition, sterilisation of the cornea by antibacterial agents does not eliminate inflammation and corneal scarring that accompany infection. Steroidal and non-steroidal antiinflammatory agents limit corneal scarring during experimentally induced bacterial keratitis. However, although promising, concomitant use of these drugs with antibacterial agents remains controversial. Two ocular drug delivery systems that provide high and sustained concentrations of drug to ocular tissues are corneal collagen shields and transcorneal iontophoresis. The collagen shield, originally designed as a bandage lens, prolongs drug contact with the cornea. Chemotherapeutic studies of experimental bacterial keratitis demonstrate that shields hydrated with antibacterial agents reduce bacteria in the cornea as well as or better than frequent applications of fortified antibacterial drops. Transcorneal iontophoresis uses an electric current to drive charged drugs into the cornea. In experimentally induced bacterial keratitis, transcorneal iontophoresis of antibacterial agents is superior to topically administered ocular drops for reducing the numbers of bacteria in the cornea. Although both drug delivery systems appear to be well tolerated and nontoxic in animal models, clinical trials in patients are required to determine the usefulness of these drug delivery systems in clinical trials. Based on present experimental results, future therapy of bacterial keratitis will involve efficient drug delivery devices, the use of new antibacterial agents or combinations of presently available antibacterial agents, and careful use of adjuvant anti-inflammatory agents.
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PMID:Pharmacokinetic considerations in the treatment of bacterial keratitis. 795 76

Infections of the cornea with herpes simplex virus type 1 cause inflammatory lesions which frequently lead to blindness. The disease is suspected to be immunopathological in nature. To establish this point and to study possible mechanisms involved, corneal infections in C.B-17 scid/scid and cell-reconstituted scid mice were investigated. Whereas unreconstituted scid mice failed to develop herpetic stromal keratitis (HSK) and died of encephalitis, mice reconstituted with T lymphocytes generated severe lesions. T cells of the CD4+ subset were found to be essential mediators of the HSK lesion, while T cells of the CD8+ subset protected mice from lethality. The results confirm that HSK is an immunopathological disease and that scid mice provide a convenient model that should prove valuable in establishing the biochemical mechanisms by which HSK is mediated.
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PMID:Herpetic stromal keratitis in the reconstituted scid mouse model. 809 78

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

Pigmented fungi were identified in ocular tissues from 2 cats and 1 dog. The first cat was euthanatized because of acute anterior uveitis that was unresponsive to treatment. On histologic examination, intraocular structures had been obliterated and replaced by a gray coagulum of inflammatory infiltrates and fungal elements. The second cat was treated for unilateral glaucoma that was unresponsive to treatment. A large retrobulbar mass, discovered and removed during an enucleation procedure, contained plant-origin foreign material. Keratitis, episcleritis, and orbital cellulitis with fungal elements were found on examination of the enucleated globe. The dog, examined because of a presumed corneal scratch of 2 weeks' duration that was unresponsive to treatment, had a corneal lesion subsequently removed by lamellar keratectomy that contained fungi on histologic examination. Infections caused by dematiaceous fungi are not common in domestic animals, and, to our knowledge, such infections in the eye have not been described.
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PMID:Ocular infections with dematiaceous fungi in two cats and a dog. 971 33


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