amphotericin-b and Conjunctivitis

Topics: Administration, Topical; Amphotericin B; Anemia, Aplastic; Anti-Infective Agents; Benzamidines; Chronic Disease; Conjunctivitis; Conjunctivitis, Allergic; Corneal Injuries; Dermatitis, Contact; Drug Eruptions; Epithelium; Humans; Idoxuridine; Keratitis; Stevens-Johnson Syndrome; Sulfonamides; Wound Healing

To report the case of a patient developing fungal keratitis in the context of uncontrolled ocular cicatricial pemphigoid (OCP), which, despite intravenous immunoglobulin (IVIg) and other immunomodulatory therapy, progressed to end-stage pemphigoid, with corneal opacification, ankyloblepharon, and xerosis. Keratoprosthesis (KPro) restored functional vision for the patient.. A 39-year-old man presented with uncontrolled CP and corneal ulcer in the left eye. Conjunctival biopsy diagnosed OCP; corneal scraping and biopsy diagnosed the cause of the corneal ulcer. OCP was treated with systemic steroids, immunosuppressive drugs, and IVIg. Visual rehabilitation was accomplished with Ahmed valve and a type II Dohlman KPro.. Immunohistology of the biopsied conjunctiva showed IgG at the epithelial basement membrane zone, confirming the clinical diagnosis of OCP. Microbiologic studies of the corneal biopsy specimen were negative for Acanthamoeba and herpes but positive for Aspergillus niger. The patient's keratomycosis resolved with topical antifungal therapy. Treatment with Dapsone, intravenous-pulse steroid, oral cyclophosphamide, and intravenous immunoglobulin (IVIg) failed to control the OCP, with resultant complete conjunctivization of the cornea. Keratoprosthesis improved the patient's visual acuity from hand movements to 20/20.. Patients with uncontrolled OCP are at increased risk of corneal infection. The difficulty in diagnosing keratomycosis and the relatively rare occurrence of OCP explain the uniqueness of our reported case. OCP may progress to "end-stage" disease despite therapy. Keratoprosthesis can restore vision in selected otherwise seemingly hopeless cases.

Topics: Adult; Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus niger; Autoimmune Diseases; Conjunctivitis; Cornea; Corneal Opacity; Corneal Ulcer; Eye Infections, Fungal; Glucocorticoids; Humans; Immunoglobulins, Intravenous; Immunosuppressive Agents; Male; Pemphigoid, Benign Mucous Membrane; Prostheses and Implants; Prosthesis Implantation

We present a case of conjunctivitis in a diabetic patient in whom not improvement was observed after empiric treatment, and finally developed a conjunctival granuloma. Culture of the conjunctival exudate and histological examination of the conjunctival biopsy confirmed the infection by Penicillium sp. The antifungical treatment (local and systemic) improved signs and symtoms gradually.. Penicillium sp is an infrequent cause of conjunctival infection. This diagnosis should be considered when no response after usual therapy to conjunctivitis is obtained and should be confirmed by identification of the fungus in the lesions biopsed and cultured. Succesful management of ocular penicilliosis is achieved with both local and systemic antifungal treatment.

Topics: Aged; Amphotericin B; Antifungal Agents; Conjunctivitis; Eye Infections, Fungal; Humans; Ketoconazole; Male; Mycoses; Penicillium; Treatment Outcome

Two cases of heroin abusers who developed disseminated candidiasis are reported. Cultures of skin lesions revealed Candida albicans, which on histology were shown to be located in and around hair shafts. Both patients recovered after treatment with amphotericin B combined with 5-fluorocytosine and either ketoconazole or dexamethasone. This unusual cutaneous syndrome of candidal infection associated with extensive folliculitis seems to be related to the use of a particular type of heroin, the so-called brown Iranian heroin.

Topics: Adult; Amphotericin B; Candidiasis; Conjunctivitis; Female; Flucytosine; Folliculitis; Heroin; Humans; Iran; Ketoconazole; Male; Substance-Related Disorders

Topics: Adult; Aged; Amphotericin B; Antifungal Agents; Candida; Candidiasis; Conjunctivitis; Cytosine; Endophthalmitis; Female; Fluorine; Humans; Infant, Newborn; Infant, Premature; Iritis; Male; Middle Aged

Topics: Actinomycosis; Amphotericin B; Animals; Antifungal Agents; Atropine; Chorioretinitis; Conjunctivitis; Eye Diseases; Hot Temperature; Humans; Laser Therapy; Light Coagulation; Mycoses; Natamycin; Nocardia Infections; Nystatin; Penicillins; Rabbits; Sporotrichosis; Streptomycin; Sulfacetamide; Sulfadiazine; Vitreous Body

Topics: Amphotericin B; Antifungal Agents; Bacteriological Techniques; Conjunctivitis; Diagnosis; Eye Infections, Fungal; Eyelids; Humans; Keratitis; Lacrimal Apparatus; Mycoses; Ophthalmology; Postoperative Complications; Skin Tests; Uveitis