RESUMEN
The purpose of this article is to describe two paediatric neuro-ophthalmological clinical cases caused by a systemic infection due to Mycoplasma pneumoniae (M. pneumoniae). The cases are two girls aged 14 and 12 seen in the Emergency Department: The first one had internuclear ophthalmoplegia and second with loss of vision and headache. They had no other neurological foci. Magnetic resonance imaging showed hyperintense plaques in both, suggestive of a demyelinating disease. One month later, the neuro-ophthalmological symptoms resolved, with normal follow-up magnetic resonance imagings. The diagnosis was acute disseminated encephalitis secondary to M. pneumoniae. The diagnosis was made using PCR (gold standard) and/or IgM in serology. It is important to think about this possible aetiology in cases of suggestive demyelinating disease. There is controversy about the role of antibiotics and on whether corticosteroids are contemplated. In conclusion, M. pneumoniae must be a differential diagnosis in acute neuro-ophthalmological disorders in children.
Asunto(s)
Ceguera/microbiología , Encefalitis Infecciosa/microbiología , Infecciones por Mycoplasma , Mycoplasma pneumoniae , Trastornos de la Motilidad Ocular/microbiología , Enfermedad Aguda , Adolescente , Niño , Femenino , HumanosRESUMEN
Whipple's disease, affecting the CNS, can cause a wide variety of symptoms. Movement disorders are very prevalent, and some are pathognomonic of the disease. This systematic review analyzed all published cases of movement disorders because of CNS Whipple's disease, providing detailed information on clinical and associated features. We have also attempted to address sources of confusion in the literature, particularly related to differing uses of the terminology of movement disorder. This comprehensive overview of Whipple's disease-induced movement disorders aims to aid neurologists in recognizing this very rare disorder and successfully reaching a laboratory-confirmed diagnosis in order to initiate appropriate therapy. © 2018 International Parkinson and Movement Disorder Society.
Asunto(s)
Trastornos del Movimiento/etiología , Trastornos de la Motilidad Ocular/etiología , Enfermedad de Whipple/complicaciones , Bases de Datos Bibliográficas , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/diagnóstico por imagen , Trastornos del Movimiento/microbiología , Trastornos de la Motilidad Ocular/diagnóstico por imagen , Trastornos de la Motilidad Ocular/microbiología , Enfermedad de Whipple/diagnóstico por imagenRESUMEN
The visual tract is prominently involved in schizophrenia, as evidenced by perceptual distortions and a type of nystagmus found in many individuals affected. Genetic explanations for these abnormalities have been suggested. This study proposes an alternate explanation based on infection. Several infectious agents thought to be associated with some cases of schizophrenia are known to cause both infection of the fetus and abnormalities of the eye. Toxoplasma gondii is examined in detail, and rubella, cytomegalovirus, varicella-zoster virus, and herpes simplex virus more briefly. Careful ophthalmic assessments, including funduscopy and direct examination of tissues for infectious agents, will clarify the role of such agents in ocular aspects of schizophrenia.
Asunto(s)
Oftalmopatías , Infecciones por Herpesviridae , Trastornos de la Motilidad Ocular , Trastornos de la Percepción , Complicaciones Infecciosas del Embarazo , Síndrome de Rubéola Congénita , Esquizofrenia , Toxoplasmosis Ocular , Percepción Visual/fisiología , Oftalmopatías/etiología , Oftalmopatías/microbiología , Oftalmopatías/fisiopatología , Femenino , Infecciones por Herpesviridae/complicaciones , Infecciones por Herpesviridae/fisiopatología , Humanos , Trastornos de la Motilidad Ocular/etiología , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/fisiopatología , Trastornos de la Percepción/etiología , Trastornos de la Percepción/microbiología , Trastornos de la Percepción/fisiopatología , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Complicaciones Infecciosas del Embarazo/fisiopatología , Síndrome de Rubéola Congénita/complicaciones , Síndrome de Rubéola Congénita/fisiopatología , Esquizofrenia/etiología , Esquizofrenia/microbiología , Esquizofrenia/fisiopatología , Toxoplasmosis Ocular/complicaciones , Toxoplasmosis Ocular/fisiopatologíaAsunto(s)
Bacteriemia/microbiología , Trombosis del Seno Cavernoso/microbiología , Infecciones Bacterianas del Ojo/microbiología , Trastornos de la Motilidad Ocular/microbiología , Neuropatía Óptica Isquémica/microbiología , Infecciones Estreptocócicas/microbiología , Streptococcus anginosus/aislamiento & purificación , Anciano , Antiinfecciosos/uso terapéutico , Anticoagulantes/uso terapéutico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Trombosis del Seno Cavernoso/diagnóstico , Trombosis del Seno Cavernoso/tratamiento farmacológico , Quimioterapia Combinada , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Femenino , Glucocorticoides/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Imagen por Resonancia Magnética , Metilprednisolona/uso terapéutico , Metronidazol/uso terapéutico , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/tratamiento farmacológico , Neuropatía Óptica Isquémica/diagnóstico , Neuropatía Óptica Isquémica/tratamiento farmacológico , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Tomografía Computarizada por Rayos XAsunto(s)
Enfermedad por Rasguño de Gato/complicaciones , Enfermedad por Rasguño de Gato/diagnóstico , Conjuntivitis/microbiología , Enfermedades Linfáticas/microbiología , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/microbiología , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Niño , Conjuntivitis/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Humanos , Ganglios Linfáticos/microbiología , Enfermedades Linfáticas/tratamiento farmacológico , Trastornos de la Motilidad Ocular/tratamiento farmacológicoRESUMEN
PURPOSE: To describe clinical, ultrasonographic, radiological and histopathological features of orbital aspergillosis in immunocompetent patients. METHODS: Medical records of immunocompetant individuals with orbital aspergillosis between November 1995 and November 2010 were reviewed. RESULTS: Thirty-five cases (27 males, 8 females) were reviewed. Mean age at presentation was 37.63 (8-73) years and mean duration of symptoms was 12.03 (0.5-84) months. Proptosis (22.63%) and mass lesion (13.37%) were the commonest presenting complaints. Presenting visual acuity was better than 6/9 in 21 (60%) and no perception of light in 3 (8%). Ocular motility restriction was noted in 25 (71%). The commonest clinical differential diagnosis was non-specific orbital inflammatory disease (NSOID) (10.29%) followed by malignancy (7.20%). CT showed infiltrative lesions with bone destruction in 22 (63%), contiguous paranasal sinus involvement in 22 (63%) and intracranial extension in 10 (29%). Diagnosis was by histopathology and microbiological evaluation. Fungal cultures revealed Aspergillus flavus in 30 (86%) and Aspergillus fumigatus in 5 (14%). Treatment included conservative medical management in 18 (51%) and surgical debulking in 17 (49%). Average follow-up was 37.6 (3-183) months, and patient survival was 33/35 (94%). CONCLUSIONS: Though orbital aspergillosis is commonly seen in immunocompromised patients, it should be suspected in young immunocompetent individuals presenting with proptosis of insidious onset and infiltrating lesions involving the paranasal sinuses. Definitive diagnosis is achieved by histopathological and microbiological evaluation. Systemic steroids should be avoided prior to definitive diagnosis. Prolonged systemic antifungal therapy with an option of additional debulking of lesions provides good disease control with improved survival.
Asunto(s)
Aspergilosis/microbiología , Aspergillus flavus/aislamiento & purificación , Aspergillus fumigatus/aislamiento & purificación , Infecciones Fúngicas del Ojo/microbiología , Inmunocompetencia , Enfermedades Orbitales/microbiología , Adolescente , Adulto , Anciano , Antifúngicos/uso terapéutico , Aspergilosis/diagnóstico , Aspergilosis/terapia , Niño , Terapia Combinada , Diagnóstico Diferencial , Infecciones Fúngicas del Ojo/diagnóstico , Infecciones Fúngicas del Ojo/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/terapia , Procedimientos Quirúrgicos Oftalmológicos , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/terapia , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/microbiología , Trastornos de la Visión/terapia , Agudeza Visual/fisiología , Adulto JovenRESUMEN
An 11-year-old-girl and a 13-year-old-boy presented with characteristic findings of Parinaud's oculoglandular syndrome. The girl was initially suspected of having Bartonella henselae infection and the boy was initially diagnosed as Francisella tularensis infection. Both children had laboratory-confirmed infection with Rickettsia typhi.
Asunto(s)
Trastornos de la Motilidad Ocular/microbiología , Rickettsia typhi , Tifus Endémico Transmitido por Pulgas/complicaciones , Tifus Endémico Transmitido por Pulgas/tratamiento farmacológico , Adolescente , Antibacterianos/uso terapéutico , Niño , Doxiciclina/uso terapéutico , Femenino , Humanos , MasculinoRESUMEN
Bartonella henselae is the causative agent of cat scratch disease, a human infection usually characterized by persistent regional lymphadenopathy. It is transmitted to humans by cat scratches or bites. Cats are the major reservoir for this bacterium thus B. henselae has a worldwide distribution. The bacterial pathogenicity may bay emphasized by the immune status of the infected host. Angiomatosis or hepatic peliosis are the most frequent clinical manifestations in immunocompromised patients. B. henselae is also responsible for endocarditis in patients with valvular diseases, and may induce various clinical presentations such as: bacteriemia, retinitis, musculoskeletal disorders, hepatic or splenic diseases, encephalitis, or myocarditis. Several diagnostic tools are available; they may be combined and adapted to every clinical setting. B. henselae is a fastidious bacterium; its diagnosis is mainly made by PCR and blood tests. No treatment is required for the benign form of cat scratch disease. For more severe clinical presentations, the treatment must be adapted to every clinical presentation.
Asunto(s)
Angiomatosis Bacilar/microbiología , Bartonella henselae/patogenicidad , Enfermedad por Rasguño de Gato/microbiología , Algoritmos , Angiomatosis Bacilar/diagnóstico , Angiomatosis Bacilar/epidemiología , Angiomatosis Bacilar/transmisión , Animales , Antibacterianos/uso terapéutico , Técnicas Bacteriológicas , Bartonella henselae/clasificación , Bartonella henselae/genética , Bartonella henselae/aislamiento & purificación , Bartonella henselae/fisiología , Enfermedades de los Gatos/microbiología , Enfermedades de los Gatos/transmisión , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/epidemiología , Enfermedad por Rasguño de Gato/transmisión , Gatos/microbiología , Reservorios de Enfermedades/microbiología , Endocarditis Bacteriana/etiología , Endocarditis Bacteriana/microbiología , Humanos , Huésped Inmunocomprometido , Enfermedades Musculoesqueléticas/etiología , Enfermedades Musculoesqueléticas/microbiología , Trastornos de la Motilidad Ocular/etiología , Trastornos de la Motilidad Ocular/microbiología , Peliosis Hepática/etiología , Peliosis Hepática/microbiología , Retinitis/etiología , Retinitis/microbiología , ZoonosisRESUMEN
PURPOSE: The purpose of this study was to assess the clinical profile and treatment outcomes in eyes with endophthalmitis presenting with orbital signs. METHODS: A case-control study of 24 eyes with endophthalmitis and orbital signs at presentation (defined as ocular motility restriction and/or presence of " inverted perpendicular" sign on ultrasonography) was conducted between January 2000 and December 2006. The control group was constituted of 40 age- and sex-matched eyes with endophthalmitis presenting without orbital signs. Optimal structural outcome was defined as resolution of inflammation and infection. Adverse structural outcome was defined as development of phthisis bulbi or need for evisceration or development of retinal detachment. Optimal functional outcome was defined as improvement in postoperative visual acuity to 3/60 or better. The Pearson chi-square test was used with appropriate significance (P < or = 0.05) to compare the mean visual acuity before and after treatment. RESULTS: Twenty-four patients with a mean age of 46.4 years and a mean follow-up of 14.6 months were included. Treatment options included intravitreal antibiotics, vitrectomy, evisceration, and systemic antibiotics. Optimal structural outcome was achieved in 6 (25%) eyes. A total of 70.8% eyes had no light perception, whereas 4 (16.66%) patients regained ambulatory vision (>3/60). There was a statistically significant poor visual (P = 0.05) and structural outcome (P = 0.004), whereas in the control group, 25 patients (62.5%) had vision 3/60 or better (P = 0.001). CONCLUSION: Orbital signs are independent risk factors for poor structural and visual outcomes in eyes with endophthalmitis.
Asunto(s)
Endoftalmitis/diagnóstico , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Fúngicas del Ojo/diagnóstico , Trastornos de la Motilidad Ocular/diagnóstico , Enfermedades Orbitales/diagnóstico , Adolescente , Adulto , Anciano , Antibacterianos/administración & dosificación , Humor Acuoso/microbiología , Bacterias/aislamiento & purificación , Estudios de Casos y Controles , Niño , Preescolar , Endoftalmitis/microbiología , Endoftalmitis/terapia , Evisceración del Ojo , Infecciones Bacterianas del Ojo/microbiología , Infecciones Bacterianas del Ojo/terapia , Infecciones Fúngicas del Ojo/microbiología , Infecciones Fúngicas del Ojo/terapia , Femenino , Estudios de Seguimiento , Hongos/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/terapia , Enfermedades Orbitales/microbiología , Enfermedades Orbitales/terapia , Factores de Riesgo , Agudeza Visual/fisiología , Vitrectomía , Cuerpo Vítreo/microbiologíaAsunto(s)
Ojo/patología , Zoonosis/microbiología , Zoonosis/parasitología , Animales , Enfermedad por Rasguño de Gato/microbiología , Enfermedad por Rasguño de Gato/patología , Enfermedad por Rasguño de Gato/transmisión , Conjuntivitis Bacteriana/microbiología , Conjuntivitis Bacteriana/patología , Conjuntivitis Bacteriana/transmisión , Cisticercosis/parasitología , Cisticercosis/patología , Cisticercosis/transmisión , Ojo/microbiología , Ojo/parasitología , Humanos , Larva Migrans/parasitología , Larva Migrans/patología , Larva Migrans/transmisión , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/patología , Toxoplasma/patogenicidad , Toxoplasmosis/parasitología , Toxoplasmosis/patología , Toxoplasmosis/transmisión , Zoonosis/transmisiónAsunto(s)
Enfermedad de Lyme/complicaciones , Trastornos de la Motilidad Ocular/microbiología , Adulto , Antibacterianos/uso terapéutico , Anticuerpos Antibacterianos/análisis , Borrelia burgdorferi/inmunología , Ceftriaxona/uso terapéutico , Humanos , Inmunoglobulina M/análisis , Neuroborreliosis de Lyme , Masculino , Meningitis Bacterianas/microbiología , Médula Espinal/inmunologíaAsunto(s)
Aspergilosis/complicaciones , Aspergilosis/patología , Enfermedades del Nervio Oculomotor/microbiología , Enfermedades del Nervio Oculomotor/patología , Sinusitis del Esfenoides/microbiología , Sinusitis del Esfenoides/patología , Anciano , Antifúngicos/uso terapéutico , Aspergilosis/fisiopatología , Blefaroptosis/microbiología , Blefaroptosis/patología , Blefaroptosis/fisiopatología , Diplopía/microbiología , Diplopía/patología , Diplopía/fisiopatología , Humanos , Hipertensión Intracraneal/complicaciones , Hipertensión Intracraneal/microbiología , Hipertensión Intracraneal/patología , Imagen por Resonancia Magnética , Masculino , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/patología , Trastornos de la Motilidad Ocular/fisiopatología , Nervio Oculomotor/anatomía & histología , Nervio Oculomotor/microbiología , Nervio Oculomotor/patología , Enfermedades del Nervio Oculomotor/fisiopatología , Recuperación de la Función/fisiología , Remisión Espontánea , Seno Esfenoidal/anatomía & histología , Seno Esfenoidal/microbiología , Seno Esfenoidal/patología , Sinusitis del Esfenoides/fisiopatología , Espacio Subaracnoideo/microbiología , Espacio Subaracnoideo/patología , Espacio Subaracnoideo/fisiopatología , Resultado del TratamientoRESUMEN
Whipple's disease of the brain is one of the most challenging neurological diagnoses. "Is it Whipple's disease?" is a frequent question, but rarely is the answer yes. The neurological manifestations do not help to distinguish primary from secondary Whipple's disease of the brain, and although MR brain scanning with gadolinium is mandatory, it can be normal and any abnormalities are non-specific. There must be a comprehensive search for multisystem involvement such as raised inflammatory markers, lymphadenopathy or malabsorption; biopsy of lymph node or duodenum may be necessary. PCR and DNA sequencing for Tropheryma whipplei on lymphocytes from blood and cerebrospinal fluid is essential. Treatment is as difficult as the diagnosis-there are no randomised controlled trials.
Asunto(s)
Encéfalo/patología , Enfermedad de Whipple/diagnóstico , Enfermedad de Whipple/terapia , Adulto , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Atrofia/microbiología , Atrofia/patología , Encéfalo/microbiología , Encéfalo/fisiopatología , Trastornos de la Conciencia/etiología , Trastornos de la Conciencia/fisiopatología , Diagnóstico Diferencial , Progresión de la Enfermedad , Quimioterapia Combinada , Femenino , Humanos , Enfermedades Linfáticas/microbiología , Enfermedades Linfáticas/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/fisiopatología , Enfermedades Raras , Espasmo/microbiología , Espasmo/fisiopatología , Resultado del Tratamiento , Tropheryma/genética , Enfermedad de Whipple/microbiologíaAsunto(s)
Músculos Masticadores/fisiopatología , Trastornos de la Motilidad Ocular/fisiopatología , Enfermedad de Whipple/diagnóstico , Enfermedad de Whipple/fisiopatología , Adulto , Antiinfecciosos/uso terapéutico , Antiinfecciosos Urinarios/uso terapéutico , ADN Bacteriano/análisis , ADN Bacteriano/líquido cefalorraquídeo , Músculos Faciales/inervación , Músculos Faciales/fisiopatología , Humanos , Enfermedades del Yeyuno/complicaciones , Enfermedades del Yeyuno/diagnóstico , Enfermedades del Yeyuno/microbiología , Masculino , Músculos Masticadores/inervación , Trastornos de la Motilidad Ocular/microbiología , Músculos Oculomotores/inervación , Músculos Oculomotores/fisiopatología , Periodicidad , Sulfametoxazol/uso terapéutico , Resultado del Tratamiento , Trimetoprim/uso terapéutico , Tropheryma/efectos de los fármacos , Tropheryma/genética , Tropheryma/fisiología , Enfermedad de Whipple/complicacionesRESUMEN
AIM: The authors describe a diagnostic approach that proved to be particularly valuable in rare cases of ocular tularemia registered during the tularemia outbreak in 1997-2005 in Bulgaria. The authors describe the laboratory findings and diagnosis of four cases with an oculoglandular form of infection. METHODS: Several different specimens from each patient were analysed. Oculoglandular tularemia was diagnosed in four patients either by culture, immunofluorescent antibody analysis (IFA), serology or by a polymerase chain reaction (PCR) assay. RESULTS AND DISCUSSION: Three F tularensis strains were isolated and characterised. One of these was isolated from a conjuctival swab specimen obtained from a seronegative patient. The authors report for the first time a successful application of diagnostic PCR performed directly on conjuctival swab specimen. From all analysed specimens IFA was diagnostically effective only in the case of lymph node aspirates and was not sensitive enough for conjuctival swabs or blood samples. The authors also describe the histological picture of a conjunctival granuloma in course of infection. All patients were successfully treated with ciprofloxacin. CONCLUSIONS: Some of the proposed laboratory diagnostic strategies (swab PCR) are not invasive and could represent a new approach for resolving rare and hard-to-diagnose cases of oculoglandular tularemia.
Asunto(s)
Infecciones Bacterianas del Ojo/diagnóstico , Tularemia/diagnóstico , Conjuntiva/microbiología , ADN Bacteriano/análisis , Francisella tularensis/genética , Francisella tularensis/aislamiento & purificación , Humanos , Trastornos de la Motilidad Ocular/microbiología , Reacción en Cadena de la Polimerasa/métodos , Tularemia/complicacionesRESUMEN
A 38-year-old immunocompetent man presented with a horizontal supranuclear gaze palsy as the only neurologic manifestation of a pontine tuberculoma. Although a biopsy of the brain lesion was not performed, it was attributed to tuberculosis because of chest x-ray evidence. The patient was given empirical anti-tuberculous therapy. After one month, the gaze palsy had fully recovered and repeat MRI showed a decrease in the size of the lesion. This is the first reported case of supranuclear gaze palsy without diplopia as a manifestation of a tuberculous brain stem lesion.
Asunto(s)
Trastornos de la Motilidad Ocular/fisiopatología , Puente/fisiopatología , Tuberculoma Intracraneal/diagnóstico , Tuberculoma Intracraneal/fisiopatología , Tuberculosis/complicaciones , Nervio Abducens/patología , Nervio Abducens/fisiopatología , Enfermedades del Nervio Abducens/microbiología , Enfermedades del Nervio Abducens/patología , Enfermedades del Nervio Abducens/fisiopatología , Adulto , Humanos , Imagen por Resonancia Magnética , Masculino , Vías Nerviosas/patología , Vías Nerviosas/fisiopatología , Trastornos de la Motilidad Ocular/microbiología , Trastornos de la Motilidad Ocular/patología , Músculos Oculomotores/inervación , Músculos Oculomotores/fisiopatología , Puente/microbiología , Puente/patología , Formación Reticular/patología , Formación Reticular/fisiopatología , Tuberculoma Intracraneal/patologíaRESUMEN
PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite the initially negative, a late onset of serologic positive titers was observed. METHODS: Case report. RESULTS: A 65-year-old man was examined for a foreign body in the left eye associated with granulomatous nodule on the palpebral conjuctiva, chemosis and a swollen preauricular lymph node. Despite the initially negative serologic titers to Bartonella henselae, a clinical diagnosis of POS was made and treatment was instituted initially with oral ciprofloxacin (500 mg twice a day). Three weeks later, serologic positive titers were found which confirmed the diagnosis of POS. CONCLUSION: Even though the improvements in diagnostic testing such as indirect immunofluorescence antibody, negative titles could be initially observed, confusing the diagnostic process. Other techniques (such as polymerase chain reaction (PCR) testing) should be also taken into consideration in cases with increased clinical suspicious of B. henselae indections.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Bartonella henselae/inmunología , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/microbiología , Trastornos de la Motilidad Ocular/microbiología , Anciano , Antiinfecciosos/uso terapéutico , Ciprofloxacina/uso terapéutico , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Enfermedades Linfáticas/diagnóstico , Enfermedades Linfáticas/microbiología , Masculino , Trastornos de la Motilidad Ocular/diagnóstico , Pruebas SerológicasRESUMEN
PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite a borderline serology, polymerase chain reaction (PCR) testing for a conjunctival biopsy was positive for Bartonella henselae, a source of cat-scratch disease. A Steiner silver stain demonstrated the organism. METHODS: Case Report. RESULTS: A 65-year-old man was seen for a foreign body in his left eye (OS) associated with chemosis and a preauricular node. CONCLUSION: B. henselae is a known cause of POS. This gram-negative pleomorphic rod has been more frequently discovered in connection with this syndrome due to improved diagnostic testing such as indirect immunofluorescence antibody and PCR testing. Frequently, serology is positive if the organism is present. This report describes a patient with clinical findings of POS who, despite borderline serology, had pleomorphic rods on Steiner silver stain and positive PCR testing compatible with Bartonella henselae.
Asunto(s)
Bartonella henselae/aislamiento & purificación , Enfermedad por Rasguño de Gato/complicaciones , Enfermedades de la Conjuntiva/microbiología , Trastornos de la Motilidad Ocular/microbiología , Anciano , Bartonella henselae/genética , ADN Bacteriano/análisis , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Tinción con Nitrato de PlataRESUMEN
The authors report one case of Parinaud's oculoglandular syndrome associated with Paracoccidioides brasiliensis infection. No other medical report of this condition was found in the medical literature available at Index Medicus and Medline. The eye involvement has been rather uncommon in paracoccidioidomycosis and this report emphasizes the possibility of this kind of presentation making it also necessary to include paracoccidioidomycosis among the several known causes of Parinaud's oculoglandular syndrome.
Asunto(s)
Conjuntivitis/microbiología , Trastornos de la Motilidad Ocular/microbiología , Paracoccidioidomicosis/complicaciones , Adulto , Conjuntivitis/patología , Humanos , Enfermedades Linfáticas/microbiología , Enfermedades Linfáticas/patología , MasculinoRESUMEN
Lemierre's syndrome, also known as postanginal sepsis, is a rare condition that presents as an increasing sore throat due to acute pharyngitis or tonsillitis and progresses to sepsis, due to suppurative thrombophlebitis of the internal jugular vein. We present an atypical case of Lemierre's syndrome complicated by carotid thrombosis. The etiological factors and the diagnostic and therapeutic measures are discussed.