amphotericin-b and Uveitis

We report here the case of a 12-year-old girl with concomitant cutaneous and ocular sporotrichosis. Sporothrix schenckii was isolated from skin lesions and aqueous humour. The difficulty in the diagnosis and treatment of this form of mycosis is discussed and the data are compared with those published in the few reports available in the literature.

Topics: Amphotericin B; Anterior Chamber; Brazil; Child; Eye Infections, Fungal; Female; Fluconazole; Humans; Paracentesis; Potassium Iodide; Sporotrichosis; Timolol; Uveitis

We report the first case of invasive ophthalmologic infection by Acrophialophora sp. that was successfully treated using voriconazole (VRCZ). Acrophialophora spp., which has been reported to be an opportunistic pathogen, is a rare thermotolerant soil fungus, but its pathogenicity remains unclear. A 77-year-old man had neutropenia and prostate carcinoma and was receiving hemodialysis. His right eye had been infected for 2 days. His conjunctiva was congested, and it partially formed an abscess. Liposomal amphotericin B (L-AMB) was administered following systemic itraconazole. However, the treatment was changed from L-AMB to systemic VRCZ and VRCZ eye drops because his eye symptoms worsened. Subsequently, his symptoms stabilized and his vision was maintained. Acrophialophora sp. was identified by analyzing regions of internal transcribed spacer and domain 1 and 2 of the ribosomal RNA gene. He completed the 7-week systemic VRCZ course. The mean minimum inhibitory concentration of VRCZ for Acrophialophora spp. has been reported to be the lowest among various antifungal agents, and our results indicated the efficacy of VRCZ treatment for Acrophialophora sp. infection. Our results suggest that invasive Acrophialophora sp. infection may require long-term therapy. Further analysis of the clinical spectrum of Acrophialophora spp. infection and adequate treatment methods are required in the future.

Topics: Adolescent; Adult; Aged; Amphotericin B; Antifungal Agents; Ascomycota; Child; Child, Preschool; Cluster Analysis; Conjunctival Diseases; DNA, Fungal; DNA, Ribosomal Spacer; Eye Infections, Fungal; Female; Humans; Immunocompromised Host; Itraconazole; Male; Microbial Sensitivity Tests; Middle Aged; Phylogeny; RNA, Ribosomal; Sequence Analysis, DNA; Treatment Outcome; Ulcer; Uveitis; Voriconazole

Topics: Adult; Amphotericin B; Animals; Anti-HIV Agents; Antiprotozoal Agents; Female; HIV Infections; Humans; Leishmania infantum; Leishmaniasis, Cutaneous; Leishmaniasis, Visceral; Uveitis

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Animals; Antiretroviral Therapy, Highly Active; Humans; Immunocompromised Host; Leishmania major; Male; Syndrome; Uveitis

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Female; Heart Atria; Heart Diseases; Humans; Infant, Newborn; Infant, Premature, Diseases; Uveitis

The incidence of systemic mycotic infections, though formerly rare, has increased dramatically over the past two decades. Candida albicans has been recognized as the most common pathogen in endogenous fungal endophthalmitis. Accurate antemortem diagnosis of disseminated candidiasis is made, however, only in a few cases. Ocular findings may often provide the first definitive clue to an underlying mycotic infection. We present four cases of candidal endophthalmitis; in each the ophthalmologist played a major role in the early diagnosis of the underlying systemic infection, allowing specific therapeutic measures to be taken. We also discuss the common predisposing factors, ocular symptoms and findings, clinical course, and response to antifungal therapy.

Topics: Aged; Amphotericin B; Candidiasis; Endophthalmitis; Eye Diseases; Female; Flucytosine; Fluorescein Angiography; Fundus Oculi; Humans; Male; Middle Aged; Retinal Diseases; Uveitis; Visual Acuity; Vitreous Body

Endophthalmia due to Candida has increased in incidence over the last few years, particularly in drug addicts. Two cases of severe bilateral Candida albicans endophthalmia are reported. Histological examination of the globes following treatment by amphotericin B i.v. and secondary vitrectomy demonstrated persistence of Candida, particularly in the preretinal membrane, in the first case. Treatment in the second case consisted of amphotericin B i.v. and 5 fluorocytosine, associated with vitrectomy and an intravitreal injection of 5 micrograms of amphotericin B. Fungal elements were absent on histological examination of the globes. Ocular Candida albicans lesions may be of exogenous origin but contamination arises more frequently from an endogenous source. The resulting endophthalmia leads to retinal nodules having a tendency to extend into the vitreous. Clinical features are fairly typical and diagnosis not a problem. General treatment consists of combined administration of amphotericin B and 5 fluorocytosine, but results are often disappointing as effective penetration of these compounds into the intraocular zone is not obtained. Early vitrectomy, when a vitreal lesion exists, offers many advantages such as the possibility to identify Candida in the removed aqueous humor. As histological examination shows persistence of Candida in the preretinal membrane, the vitrectomy should be combined with intravitreal injections of amphotericin B.

Topics: Aged; Amphotericin B; Candidiasis; Endophthalmitis; Female; Humans; Uveitis; Visual Acuity; Vitreous Body

Topics: Adult; Amphotericin B; Female; Heroin Dependence; Humans; Male; Mycoses; Uveitis

Topics: Amphotericin B; Candidiasis; Flucytosine; Humans; Male; Middle Aged; Uveitis

Topics: Amphotericin B; Blastomyces; Blastomycosis; Ectropion; Humans; Male; Middle Aged; North America; Skin Diseases, Infectious; Uveitis

Topics: Adolescent; Adult; Amphotericin B; Anti-Bacterial Agents; Candida albicans; Candidiasis; Catheterization; Cytosine; Endophthalmitis; Female; Fluorine; Fundus Oculi; Humans; Male; Middle Aged; Sepsis; Uveitis

Topics: Agglutination Tests; Amphotericin B; Antigens; Blindness; Cataract; Cerebrospinal Fluid; Cryptococcosis; Cryptococcus; Culture Media; Humans; Hypertonic Solutions; Male; Methods; Middle Aged; Retinal Detachment; Rubber; Sucrose; Triamcinolone; Uveitis

Topics: Adolescent; Adult; Aged; Amphotericin B; Child; Child, Preschool; Female; Histoplasmosis; Humans; Infant; Male; Middle Aged; Uveitis

Topics: Adult; Amphotericin B; Chorioretinitis; Female; Histoplasmosis; Humans; Male; Middle Aged; Uveitis

Topics: Adult; Aged; Amphotericin B; Antifungal Agents; Eye Diseases; Female; Glaucoma; Humans; Male; Middle Aged; Mycoses; Uveitis

Topics: Acremonium; Amphotericin B; Aqueous Humor; Blood; Cataract Extraction; Drug Therapy; Endophthalmitis; Eye Diseases; Geriatrics; Humans; Injections, Intravenous; Keratitis; Mycoses; Pharmacology; Postoperative Complications; Uveitis

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

Topics: Amphotericin B; Antifungal Agents; Chorioretinitis; Histoplasmosis; Retinitis; Uveitis