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

Two patients with therapy resistant keratitis are described. There were no predisposing diseases. Both patients had been using rigid contact lenses for more than 10 years and both cleaned their lenses in cold tap water. The patients presented with keratitis of several weeks duration resistant to antibacterial and antiviral treatment and not responding to high doses of corticosteroids. Ultimately, after the possibility of a protozoan aetiology had been considered, culture of corneal scrapings from both patients yielded growth of Acanthamoeba trophozoites. Acanthamoeba keratitis is very rare in northern European countries and has never before been diagnosed in Norway. The present cases show that Acanthamoeba should be added to the list of possible pathogenic agents even in northern low temperature areas.
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PMID:Acanthamoeba keratitis; report of the first Norwegian cases. 147 98

Acanthamoeba may cause a severe keratitis in contact lens wearers. Since most sterilization techniques require rinsing the lenses prior to insertion, contaminated solutions represent a potential vector for transmission of Acanthamoeba. The ability of rinse solutions to sustain an inoculum of Acanthamoeba polyphaga was investigated. A. polyphaga was exposed to 0.1% benzalkonium chloride, 0.001% thimerosal/0.1% edetate disodium, 0.1% edetate disodium, saline, tap water, and distilled water. The status of the organism was evaluated with direct microscopic counts and cultures to confirm viability. Incubation with 0.1% edetate disodium, saline, tap water, and distilled water resulted in the maintenance of reduced populations of viable organisms for 7 days. Benzalkonium chloride preserved saline and solutions containing thimerosal with edetate rendered the Acanthamoeba nonviable.
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PMID:Survival of Acanthamoeba in contact lens rinse solutions. 212 39

Because Acanthamoeba keratitis associated with contact lenses were described, several solutions used in stationary eye wash stations were contaminated by free-living amoebae. 0.9% sodium chloride rinsing solutions allowed cyst and trophozoite growth and only one solution for decontamination using hydrogen peroxide led to rapid elimination of cysts and trophozoites. Antiseptic solutions containing ammonium derivatives or chlorhexidine killed only trophozoites. Because of the constant contamination of tap water with Acanthamoeba cysts resistant to chlorine, the prevention of amoebic keratitis in wearers of contact lenses needs: use of sterile solutions for decontamination or rinsing, choice, if possible, of oxidizing solutions, suppression of tap water for rinsing.
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PMID:[Possibility of the survival of free-living amoebae which cause keratitis in decontamination solutions used for the maintenance of contact lenses]. 279 May 30

A soft contact lens patient complained of persistent redness, blurry vision and photophobia of the right eye. Both tap water and distilled water were used in his contact lens care regimen. Atypical corneal epithelial dendriform patterns were noted and the patient was treated for presumed herpes simplex keratitis and corneal erosion. The definitive diagnosis of Acanthamoeba dendriform keratitis was made upon isolation of the offending organism from the patient's contact lens case. The clinical course is presented to help define early clinical signs of the disease.
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PMID:Acanthamoeba dendriform keratitis. 291 6

A previously healthy 53-year-old man had keratitis of the right eye for six months, unresponsive to topical medical therapy. Acanthamoeba was grown from tissue obtained by corneal biopsy and from aqueous from an anterior chamber tap. The patient was treated with propamidine isethionate 0.1% drops and dibromopropamidine isethionate 0.15% ointment, and after two and a half months the ocular inflammation was continuing to resolve. This case supports a role for the diamidines in the treatment of acanthamoebic keratitis.
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PMID:Acanthamoebic keratitis diagnosed by paracentesis and biopsy and treated with propamidine. 367 41

Microbial keratitis can occur in association with contact lens wear. The absolute risk of infection is low but may be enhanced as a consequence of increased exposure to potentially pathogenic microbes in a hospital setting. There is variation in risk depending on type of lens worn and its modality of use. Extended-wear lenses carry the greatest risk. Pseudomonas aeruginosa and Acanthamoeba are causes of potentially devastating ocular infections in contact lens wearers. The risk of these infections could be reduced by fastidious hygiene practice. Hydrogen peroxide disinfection is recommended when a storage case is included in the care regimen. This should be cleaned thoroughly and dried prior to disinfection and never exposed to tap water. Daily wear of one-day 'disposable' soft contact lenses or use of rigid gas permeable lenses is recommended for hospital staff. Contact lenses should be removed immediately and discarded or disinfected if the eye becomes contaminated and/or use of an eyewash is required.
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PMID:Contact lens wear by hospital health care staff: is there cause for concern? 756 Sep 62

Although ocular manifestations of Lyme disease have long been noted, they remain a rare feature of the disease. The spirochete invades the eye early and remains dormant, accounting for both early and late ocular manifestations. A nonspecific follicular conjunctivitis occurs in approximately 10% of patients with early Lyme disease. Keratitis occurs often within a few months of onset of disease and is characterized by nummular nonstaining opacities. Inflammatory syndromes, such as vitritis and uveitis, have been reported; in some cases, a vitreous tap is required for diagnosis. Neuro-ophthalmic manifestations include neuroretinitis, involvement of multiple cranial nerves, optic atrophy, and disc edema. Seventh nerve paresis can lead to neurotrophic keratitis. In endemic areas, Lyme disease may be responsible for approximately 25% of new-onset Bell's palsy. Criteria for establishing that eye findings can be attributed to Lyme disease include the lack of evidence of other disease, other clinical findings consistent with Lyme disease, occurrence in patients living in an endemic area, positive serology, and, in most cases, response to treatment. Management of ocular manifestations often requires intravenous therapy.
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PMID:Ocular manifestations of Lyme disease. 772 93

Acanthamoeba keratitis seems to be associated with wearing contact lenses. As controls, we surveyed contact lens wearers without keratitis. Contact lens solutions of 93 persons were examined in order to identify risk factors for contamination by Acanthamoeba. Therefore, the contact lens disinfection system and storage schedules were studied in each case. Acanthamoeba organisms were isolated from 4 specimens (4.3%). The incidence of Acanthamoeba was higher in specimens of soft contact lens solution than in those of hard contact lens solution, and all the Acanthamoeba positive cases had been using tap water.
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PMID:[Acanthamoeba isolation from contact lens solution of contact lens wearers without keratitis]. 819 18

Acanthamoebic keratitis is still a rare infection. It occurs in contact lens-wearers, especially when saline is prepared at home from contaminated tap water. There are periods of remission, and occasionally misleading findings resembling those of herpetic keratitis, which make the diagnosis difficult. The isolation of the acanthamoeba is not easy and special culture media are required. Early recognition and aggressive therapy with antiamebic medication and epithelial debridement, often in conjunction with penetrating keratoplasty, are needed. We describe the clinical course, laboratory diagnosis and treatment of 3 patients with acanthamoebic keratitis, 2 men aged 20 and 25, respectively and a women aged 42.
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PMID:[Acanthamoebic keratitis]. 825 1

A case of endogenous fungous endophthalmitis with secondary pupillary block glaucoma and corneal invasion requiring penetrating keratoplasty is reported. Initially Paecilomyces lilacinus was isolated from a vitreous and a lens aspirate, but a second vitreous tap revealed Aspergillus fumigatus and P lilacinus. This case highlights the difficulty of diagnosing endogenous fungous endophthalmitis presenting without risk factors and the difficulties of managing such cases using the antifungous agents available. To our knowledge, this is the first case report documenting a progression to stromal keratitis from endogenous endophthalmitis secondary to P lilacinus.
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PMID:Paecilomyces lilacinus endophthalmitis with secondary keratitis: a case report and literature review. 933 82


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