heroin and Eye-Diseases

Topics: Cannabis; Cocaine; Eye Diseases; Heroin; Humans; Illicit Drugs; Lysergic Acid Diethylamide; Methamphetamine; N-Methyl-3,4-methylenedioxyamphetamine

Seven young men developed disseminated candidiasis within 10 days of a single episode of intravenous heroin abuse. Sequential development of eye and skin lesions was noted in all cases. The bone or costal cartilage was involved in five. Ocular manifestations of candidiasis included episcleritis, chorioretinitis, and endophthalmitis. A presumptive diagnosis of candida chorioretinitis was established rapidly by culture of Candida albicans from involved skin and costal cartilage. Systemic therapy with amphotericin B plus 5-fluorocytosine resulted in cure of the episcleritis, chorioretinitis, osteomyelitis, costochondritis, and skin infection. Pars plana vitrectomy with local instillation of amphotericin B was required to cure chorioretinitis associated with vitreal extension of infection.

Topics: Adult; Amphotericin B; Candidiasis; Eye Diseases; Flucytosine; Heroin; Humans; Male; Substance-Related Disorders

Twenty-five ambulatory patients with acquired immunodeficiency syndrome (AIDS) were studied over a 6-month period. Fourteen (56%) of the patients were heterosexuals with a history of intravenous drug abuse. Ocular involvement was seen in 40% of patients, cotton-wool spots being the major manifestation. Findings consistent with cytomegalovirus retinitis were seen in only one patient. Ophthalmologists should be aware of the ocular findings and epidemiology of AIDS.

Topics: Acquired Immunodeficiency Syndrome; Adult; Cytomegalovirus Infections; Eye Diseases; Female; Fluorescein Angiography; Heroin; Humans; Male; Middle Aged; Retinal Diseases; Retinitis; Sarcoma, Kaposi; Skin Neoplasms; Substance-Related Disorders

Seven young men developed similar manifestations of disseminated candidiasis after a single episode of intravenous heroin abuse. Sequential development of lesions of the eye, skin, and bone or costal cartilage was noted within 10 days after injection. Skin lesions were confined to the scalp and other hair bearing areas. Candida albicans was cultured readily from affected skin and costal cartilage. Histological examination of scalp biopsy specimens showed infiltration of hair follicles with chronic inflammatory cells and C albicans. Pseudohyphas of C albicans were also identified in and around hair shafts. The skin, skeletal, and small eye lesions resolved on systemic treatment with 1 g amphotericin B plus flucytosine. Pars plana vitrectomy plus local instillation of amphotericin B cured progressive chorioretinitis. These features may represent a distinctive syndrome of disseminated candidiasis in heroin abusers. Systemic antifungal treatment is curative in most cases.

Topics: Candidiasis; Candidiasis, Cutaneous; Eye Diseases; Heroin; Humans; Male; Osteochondritis; Osteomyelitis; Ribs; Substance-Related Disorders; Syndrome

Two patients with talc emboli of the retinal vasculature, both of them intravenous drug abusers, are described. One underwent a pars plana vitrectomy for removal of the vascularized vitreous mass that obscured the retina. The vitreous mass was presumably a result of retinal neovascularization secondary to the talc embolic. Other ocular findings that may be observed in the intravenous drug abuser are described.

Topics: Adult; Embolism; Eye Diseases; Female; Heroin; Humans; Injections, Intravenous; Methylphenidate; Neovascularization, Pathologic; Retinal Vessels; Substance-Related Disorders; Talc; Vitreous Body

A case of bilateral necrotizing scleritis due to Aspergillus oryzae is reported. The patient was a former addict of intravenous narcotics treated five years previously for meningitis due to the same organism. A seeding focus in the thoracic spine was eventually found. The patient responded well to combined local and systemic therapy with amphotericin B, flucytosine, and natamycin. This represents, to the best of our knowledge, both the first reported case of ocular disease due to this species of Aspergillus and of isolated scleral, nonintraocular involvement in endogenous oculomycosis.

Topics: Adolescent; Adult; Amphotericin B; Aspergillosis; Aspergillus oryzae; Child; Cocaine; Eye Diseases; Female; Flucytosine; Heroin; Humans; Inflammation; Injections, Intravenous; Meningitis; Natamycin; Sclera; Substance-Related Disorders

Candida endophthalmitis after intravenous heroin is described. Our patient had an initial rapid deterioration on systemic corticosteroids. Systemic amphotericin B, 5 flucytosine, vitrectomy and retinal surgery were required to achieve a final visual acuity of 6/24. The difficulty of an early diagnosis and the deleterious effect of corticosteroid use are emphasized.

Topics: Adult; Candidiasis; Eye Diseases; Heroin; Humans; Inflammation; Injections, Intravenous; Male; Substance-Related Disorders

Topics: Adult; Eye Diseases; Heroin; Humans; Male; Military Personnel; Pupil; Substance Withdrawal Syndrome; Substance-Related Disorders; United States; Vietnam

Topics: Adult; Amphetamine; Aspergillosis; Cannabis; Eye Diseases; Heroin; Humans; Inflammation; Injections, Intravenous; Lysergic Acid Diethylamide; Male; Methylphenidate; Morphine Dependence; Mycoses; Substance-Related Disorders