Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A middle-aged man had blurred vision, redness, and pain in the right eye. Ophthalmoscopic examination revealed slowly progressive necrotizing retinitis in the peripheral superonasal quadrant. The clinical impression was toxoplasmic retinochoroiditis, but lesions failed to respond to steroids, pyrimethamine, and sulfonamides. The eye was enucleated and, histopathologically, showed necrotizing granulomatous retinochoroiditis and optic neuritis, numerous cigarshaped, yeast-like organisms located within the necrotic retina and subretinally, and a subretinal asteroid body. Organisms were identified as Sporotrichum schenkii by immunofluorescence techniques. Electron microscopical studies of the fungus disclosed an unusually thickened capsule with a well-developed cell wall, the outer portion of which exhibited a radiating pattern of granular filamentous material. The ability of S schenkii to cause endophthalmitis in a patient without apparent primary infection should be remembered in the differential diagnosis of a cryptogenic, slowly progressive intraocular infection.
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PMID:Granulomatous necrotizing retinochoroiditis caused by Sporotrichum schenkii. Report of a case including immunofluorescence and electron microscopical studies. 78 27

We report a case of presumed cryptococcal endophthalmitis that occurred in a patient with severe disseminated cryptococcosis and AIDS. Multiple small, spherical lesions appeared bilaterally on the surface of the retina 2 weeks after cryptococcal meningitis was diagnosed; the lesions were associated with multiple blind spots, blurred vision, and the perception of flaring of light. Over the next week, many more lesions with adjacent hemorrhages appeared. Therapy with itraconazole over the next 3 months resulted in complete resolution of the lesions. Cryptococcal endophthalmitis is a rare disease. Fewer than 20 cases, including five in patients with AIDS, have previously been reported. None of these patients regained normal vision.
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PMID:Endophthalmitis in a patient with disseminated cryptococcosis and AIDS who was treated with itraconazole. 166 51

1. Aspergilli are unique fungi found in soil, household dust, and vegetable matter. 2. Blurred vision is the most common early complaint of Aspergillus-induced endophthalmitis. It may be accompanied by pain, photophobia, and iridocyclitis. Later visual loss can be significant. 3. Retinal findings include cloudy vitreous, preretinal and subretinal exudate, and retinal hemorrhages. 4. Treatment is a pars plana vitrectomy with vitreous biopsy and intravitreal injection of amphotericin B.
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PMID:Aspergillus-induced endophthalmitis. 761 85

We report the frequency and type of infectious ocular complications following orthotopic liver transplantation (OLT) and review diagnostic and therapeutic strategies. During the period September 1988 through November 1994, 684 patients underwent OLT at Mount Sinai Hospital (New York). Nine orthotopic liver transplant patients (1.3%) developed ocular infections: Candida albicans endophthalmitis (2), Aspergillus fumigatus endophthalmitis (1), cytomegalovirus retinitis (4), herpes simplex virus keratitis (1), and varicella-zoster virus panophthalmitis (1). The mean time from OLT to ocular symptoms was 42 days for patients with fungal infections and 128 days for patients with viral infections. Blurred vision was the commonest symptom (five of nine cases). The mean duration of follow-up was 2 years (range, 33 days to 5 years). Permanent loss of vision occurred in three patients, five had improvement in visual acuity, and one died of disseminated aspergillosis 33 days after OLT. Infectious ocular complications following OLT may occur as isolated events or with disseminated disease. Fungal infections occur earlier (mean, 42 days after OLT) than viral infections (mean, 4 months after OLT). The clinical presentation may be atypical; aggressive vitreoretinal procedures and serial examinations may be required to establish the diagnosis. Cytomegalovirus retinitis in orthotopic liver transplant patients may not require life-long maintenance therapy with antiviral agents.
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PMID:Infectious ocular complications in orthotopic liver transplant patients. 919 78

A young alcoholic and heavy smoker was admitted because of Klebsiella pneumoniae bacteremia. The abdominal and pelvic computed tomography with enhancement revealed an abscess in the right prostate. He experienced blurred vision of his left eye on the third day during admission. Initial ocular examination revealed mild reaction in the anterior chamber and vitreous as well as multiple Roth's spots in the retina. The administration of empirical antibiotics including cefazolin and gentamicin intravenously was changed to ceftriaxone and amikacin after ophthalmologic consultation. After parenteral antibiotics for 3 weeks, the systemic condition was controlled, and the vision remained stable. During the past decades, many cases of endogenous Klebsiella pneumoniae endophthalmitis associated with liver abscess were reported in Taiwan. However, documented reports of this condition associated with a prostate abscess are rare. This case, classified as posterior focal endogenous endophthalmitis, had good prognosis under appropriate antibiotic treatment. Early diagnosis and prompt therapy are important for control of sepsis and restoration of vision.
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PMID:Endogenous Klebsiella pneumoniae endophthalmitis associated with prostate abscess: case report. 1090 31

Endogenous endophthalmitis is a rare but devastating complication of bacteremia. Klebsiella pneumoniae is reported to be the leading organism of endogenous endophthalmitis in Taiwan, and the prognosis of endogenous Klebsiella pneumoniae endophthalmitis is extremely poor. A 46-year-old male patient was hospitalized because of fever, chills, and consciousness disturbance for 1 day. Meningitis was the impression by clinical presentation and findings of cerebrospinal fluid analysis. Parenteral ceftriaxone (4 g/day) and gentamicin (180 mg/day) were given, and his consciousness gradually cleared. On hospital day 6, he complained of blurred vision in both eyes and floaters in the left eye for 1 day. After ophthalmic examination, bilateral endogenous endophthalmitis was diagnosed. After aggressive treatment with intravitreal antibiotics and trans pars plana vitrectomy, the visual outcome of both eyes was better than those of other reported cases.
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PMID:Bilateral endogenous Klebsiella pneumoniae endophthalmitis associated with meningitis-useful vision regained after treatment: case report. 1109 47

Infectious endophthalmitis can be caused by organisms from the environment entering the eye after ocular surgery (62%) or after penetrating ocular trauma (20%) (exogenous endophthalmitis), or can result from hematogeneous spread of organisms to the eye (8%) (endogenous endophthalmitis). Endophthalmitis is the most dreaded ocular infection, and carries one of the worst visual prognoses of all ocular infections. The symptoms of endophthalmitis are blurred vision, redness, and pain. The signs include conjunctival hyperemia, anterior chamber and vitreous cell, hypopyon, lid edema, chemosis, corneal edema, reduced red reflex, and afferent pupillary defect. The main treatment is intravitreal antibiotics used in conjunction with subconjunctival, topical, and intravenous antibiotics and corticosteroids.
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PMID:Infectious Endophthalmitis. 1109 85

Postoperative endophthalmitis is one of the most serious complications after cataract surgery though its frequency may be low. We report a case with post-cataract extraction bacterial endophthalmitis treated favorably by core vitrectomy through pars plana with anterior vitrectomy cutter (A-vit). The patient, a 72-year-old woman, presented with blurred vision 7 days after phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. Her initial visual acuity was counting fingers. As hypopyon and corneal edema progressed in a few hours, we decided to perform vitectomy. Firstly, we performed IOL explantation and anterior vitrectomy through the corneal stab incision with A-vit attached to the phaco machine. The inflammation, however, appeared to be severe. Secondly we performed core vitrectomy with the same cutter as we used in the first operation through pars plana as well as intravitreal injection of vancomycin on the following day. The inflammation was gradually subsided and her corrected visual acuity was recovered to 30/20 at 7 months after the vitrectomy. The results is suggest that for cataract surgeons in the facilities that are not equipped with 3-port vitrectomy machine, post-cataract extraction bacterial endophthalmitis of the emergency stage can be successfully treated by core vitrectomy through pars plana as well as intravitreal injection of antibiotics with neither vitreous shaving at the vitreous base nor artificial posterior vitreous detachment.
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PMID:Post-cataract surgery endophthalmitis treated with core vitrectomy: a case report. 1551 53

A 55-year-old man suffered from blurred vision of the left eye (visual acuity was counting fingers/5-10 cm) 8 days after undergoing cataract surgery. After thorough ophthalmologic examinations with gram-negative bacillus justified on smear of vitreous specimen, postoperative endophthalmitis (os) was impressed. Intravitreous injection of 1.0 mg of vancomycin, 0.4 mg of amikacin, and 0.4 mg of dexamethasone was given twice and vitreous fluid culture was also performed. However, the inflammatory condition was not well controlled. Because the results of vitreous fluid culture revealed Flavimonas oryzihabitans infection which is sensitive to piperacillin, we performed the 3rd intravitreous injection of 1.0 mg of piperacillin and 0.4 mg of dexamethasone. The inflammatory condition was under control and the visual acuity of left eye improved. For patients with ocular diseases, postoperative endophthalmitis by Flavimonas oryzihabitans is a rare condition. According to the results of this case, intravitreous injection of piperacillin was effective against the pathogen.
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PMID:Postoperative endophthalmitis by Flavimonas oryzihabitans. 1579 59

A 25-year-old white, HIV-positive, immuno-competent man was referred to us because of a progressive blurred vision in his right eye. Clinical characteristics were suggestive for an unilateral fungal endophthalmitis, and thereby fluconazole firstly, followed by conventional amphotericin B were intravenously administered, without any significant improvement. Thus, a pars plana vitrectomy was performed. Aspergillus versicolor was isolated from the cultures of the vitreous sample and intravenous liposomal amphotericin B was administered. An increase of visual acuity together with a reduction of vitreous inflammation occurred. This case of ours represents the first report describing an endogenous endophthalmitis induced by Aspergillus versicolor.
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PMID:Endogenous Aspergillus versicolor endophthalmitis in an immuno-competent HIV-positive patient. 1620 76


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