trimethoprim--sulfamethoxazole-drug-combination and Retinal-Detachment

A 20 year-old healthy patient consulted due to acute loss vision in his left eye. A fundus examination showed a macular alteration compatible with unifocal helioid choroiditis, characterized by being an atypical inflammatory yellow-white, round, single lesion of approximately an optic disc in diameter. The etiology study detected low Antitoxoplasma gondii Ig G (immunoglobulin) titers.. The non-specificity of the serology and the atypical characteristics of the lesion is a limitation in the diagnosis. The Goldmann-Witmer coefficient may be useful in the diagnosis of atypical lesions, by comparing the concentration of IgG from the serum and aqueous humor.

Topics: Algorithms; Antibodies, Protozoan; Aqueous Humor; Choroiditis; Fluorescein Angiography; Humans; Immunoglobulin G; Male; Prednisolone; Retinal Detachment; Retinal Hemorrhage; Toxoplasma; Toxoplasmosis, Ocular; Trimethoprim, Sulfamethoxazole Drug Combination; Vision Disorders; Young Adult

A 45-year-old patient with cat scratch disease presented with bilateral panuveitis as well as bilateral serous detachment of the retina. The patient had suffered from influenza with swollen lymph nodes 2 weeks previously.. The diagnosis could be made serologically: IgG and IgM antibodies against Bartonella henselae were highly positive in the immunofluorescence test and the values for inflammation were also strongly increased.. A macular star developed during the course, more in the left eye than in the right eye. The patient was treated with a sulfonamide (Bactrim forte) and prednisolonacetate (Urbason), which was changed to doxyzycline (Doxybene) after an allergic reaction developed. Clinical findings were reduced significantly and visual acuity improved.. Bartonella henselae should be excluded when panuveitis occurs with serous retinal detachment. A uveitis anterior could precede this occurrence.

Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Female; Humans; Methylprednisolone; Middle Aged; Panuveitis; Retinal Detachment; Serous Membrane; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Cat-scratch disease is a self-limited infection characterized by subacute regional lymphadenitis, which is usually preceded by a history of being scratched by a cat infected with the Bartonella species. Neuroretinitis, retinochoroiditis, isolated papillitis and peripapillary angiomatosis are features of posterior segment involvement. However, vision loss is very rare. We report a patient with cat-scratch disease associated with unilateral neuroretinitis and peripapillary serous retinal detachment, and discuss its fluorescein and indocyanine green angiographic features.

Topics: Adolescent; Animals; Anti-Infective Agents; Cat-Scratch Disease; Cats; Fluorescein Angiography; Humans; Indocyanine Green; Lymph Nodes; Male; Retinal Detachment; Retinitis; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity