trimethoprim--sulfamethoxazole-drug-combination and Retinal-Diseases

We report a case of toxoplasmosis with bilateral maculopathy in a 7-year-old boy diagnosed with ataxia telangiectasia (AT) at age 6. AT manifests as ataxia, apraxia, telangiectasia, and dysarthria. Common ophthalmologic findings in AT include fine conjunctival telangiectasia. Patients also suffer from recurrent sinopulmonary infections; however, serious opportunistic infection is rarely diagnosed. At 8 years of age he developed disseminated Toxoplasma gondii (toxoplasmosis) infection and meningoencephalitis. This ophthalmologic finding and the subsequent toxoplasmosis meningoencephalitis have not been previously reported in AT.

Topics: Anti-Infective Agents; Ataxia Telangiectasia; Cerebrospinal Fluid; Child; Conjunctival Diseases; Eye Infections, Parasitic; Humans; Magnetic Resonance Imaging; Male; Polymerase Chain Reaction; Retinal Diseases; Tomography, Optical Coherence; Toxoplasma; Toxoplasmosis, Ocular; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Abscess; Aged, 80 and over; Amikacin; Anti-Bacterial Agents; Brain Abscess; Ceftriaxone; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Magnetic Resonance Imaging; Male; Microbial Sensitivity Tests; Native Hawaiian or Other Pacific Islander; Nocardia; Nocardia Infections; Retinal Diseases; Trimethoprim, Sulfamethoxazole Drug Combination; Vitrectomy

Topics: Abscess; Acetamides; Adult; Anti-Infective Agents; Ciprofloxacin; Diagnosis, Differential; Female; Humans; Immunocompromised Host; Linezolid; Nocardia; Nocardia Infections; Oxazolidinones; Retinal Diseases; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

To report a case of subretinal abscess due to Nocardia farcinica resistant to trimethoprim-sulfamethoxazole in a patient with systemic lupus erythematosus on immunosuppressive therapy.. Observational case report.. We retrospectively studied the medical record of a patient with nocardiosis.. The microorganism disseminated from the lungs (pneumonia) to the eye and brain. The ocular lesion appeared to be a yellowish, lobulated subretinal abscess with irregular surface and superficial retinal hemorrhages. As it was not responding to empiric therapy for nocardia, pars plana vitrectomy and aspiration of the subretinal material was performed to confirm the etiology.. In an immunocompromised patient with pulmonary involvement and a subretinal abscess with a characteristic aspect, one should consider nocardia as a possible etiology taking into account its possible antibiotic resistances.

Topics: Abscess; Adult; Anti-Bacterial Agents; Ciprofloxacin; Combined Modality Therapy; Eye Infections, Bacterial; Female; Humans; Lupus Erythematosus, Systemic; Nocardia; Nocardia Infections; Retinal Diseases; Retrospective Studies; Trimethoprim Resistance; Trimethoprim, Sulfamethoxazole Drug Combination; Vitrectomy

PATIENTS AND METHODS We present a 57-year-old white man with progressive deterioration of vision, who had a prolonged history of weakness, migratory arthralgias and loss of weight. Bilateral panuveitis, with iritis, inflammatory vitreous opacities associated with small, round, grayish retinal lesions. The duodenum showed a swollen mucosa, which was flecked over with pinpoint grayish grains. A small-bowel biopsy disclosed PAS-positive granules in the macrophages of the lamina propria mucosa, pathognomonic of Whipple's disease. RESULTS After antibiotic treatment with trimethoprim and sulfamethoxazole there was no relapse of the panuveitis during the follow-up period of 18 months.

Topics: Humans; Intestinal Mucosa; Male; Middle Aged; Ophthalmoscopy; Retina; Retinal Diseases; Trimethoprim, Sulfamethoxazole Drug Combination; Uveitis, Anterior; Vitreous Body; Whipple Disease