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)

Toxoplasmic retinochoroiditis is an important opportunistic retinal infection in immunodeficiency and elderly patients. The diagnosis of toxoplasmic retinochoroiditis is based primarily on characteristic ocular findings, with supportive serological evidence. It may present as diffuse necrotizing retinitis instead of a focal lesion. We report the original case of a 74-year-old woman who presented with blurred vision in her left eye lasting 3 months. In her medical history, the patient described a tuberculous infection evolving for some months, as well as agranulocytosis treated with Rifadine. Fundus examination revealed diffuse necrotizing retinitis, mainly at the nasal quadrant, with marked vitreitis in the left eye. Clinical recognition of atypical presentations is critical for timely antiparasitic drug therapy. This case initially was misdiagnosed as acute retinal necrosis syndrome. The correct diagnosis was confirmed by response to polymerase chain reaction studies of an intraocular specimen and histopathological analysis. The extensive necrotizing retinitis was nonhemorrhagic but associated with retinal detachment. Significant visual loss accompanied the infection. Toxoplasmosis should be considered as a cause of diffuse necrotizing retinitis in elderly and immunosuppressive patients. Older patients may be more susceptible to severe ocular Toxoplasma infections because of age-related decline in cell-mediated immunity and chronic underlying diseases.
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PMID:[Toxoplasma gondii and necrotizing retinitis: a case report]. 1458 27

BACKGROUND This study aimed to determine clinical outcomes using various drugs during tuberculosis (TB) treatment among living donor liver transplant (LDLT) recipients with TB and to assess the impact of performing LDLT in patients with active TB at the time of LDLT. MATERIAL AND METHODS Out of 1313 LDLT performed from June 1994 to May 2016, 26 (2%) adult patients diagnosed with active TB were included in this study. Active TB was diagnosed using either TB culture, PCR, and/or tissue biopsy. RESULTS The median age was 56 years and the male/female ratio was 1.6: 1. Most patients had pulmonary TB (69.2%), followed by extrapulmonary and disseminated TB (15.4% each). Fourteen (53.8%) patients underwent LDLT even with the presence of active TB. All patients concurrently received anti-TB [Rifampicin-based: 13 (50%); Rifabutin-based: 12 (46.2%); INH-based: 1 (3.8%)] and immunosuppressive drugs [Tacrolimus-based: 6 (23%); Sirolimus/Everolimus-based: 20 (77%)]. During treatment, adverse drug reactions (ADR) occurred in 34.6% of patients: acute rejection in 6 (23.1%), hepatotoxicity in 2 (7.7%), and blurred vision in 1 (3.8%). Twenty-three (88%) patients completed their TB treatment. Neither TB recurrence nor TB-specific mortality were observed. Three (11.5%) patients died of non-TB-related causes. The overall 5-year survival rate was 86.2%. Patients with ADRs had a higher incidence of incomplete TB treatment (log-rank: p=0.012). Furthermore, patients with incomplete treatment were significantly associated with decreased overall survival (log-rank: p<0.001). Immunosuppressive and anti-TB drugs used during TB treatment and performing LDLT in patients with active TB at the time of LDLT were not associated with ADRs and overall survival. CONCLUSIONS Outcomes are generally favorable with intensive peri-operative evaluation and surveillance. ADRs and incomplete TB treatment may result in poor prognosis and increased mortality rates.
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PMID:Clinical Outcomes of Tuberculosis in Recipients After Living Donor Liver Transplantation. 3033 16