BackgroundPost-kala-azar dermal leishmaniasis is a well-known immunologic cutaneous reaction. There are few case reports of ocular leishmaniasis. It is a sight-threatening condition that needs to be rapidly recognized and treated to avoid permanent visual loss. Ocular leishmaniasis panuveitis can present with severe inflammation in patients with highly active anti-retroviral therapy (HAART)-induced immune reconstitution syndrome.FindingsA case of a 40-year-old man, human immunodeficiency virus (HIV) positive on HAART, with a presumed diagnosis of ocular leishmaniasis, is presented. He had a past history of visceral leishmaniasis and was referred to the uveitis service with rapidly worsening panuveitis and counting fingers vision in both eyes. On empirical anti-leishmania therapy and systemic steroids, the visual acuity of the left eye improved to 6/9 but remained poor in the right eye. Based on the medical history, improvement with therapy and the exclusion of other common infections, a presumed diagnosis of ocular leishmaniasis-related panuveitis was made.ConclusionsA major immune reaction against lingering parasites may play a key role in the pathogenesis of this sight-threatening and rapidly progressive condition. Both the infection and the immune reaction should be treated.Electronic supplementary materialThe online version of this article (doi:10.1186/s12348-014-0021-0) contains supplementary material, which is available to authorized users.
There is an urgent need to address a crisis in our society, which finds traumatised pregnant women giving birth alone and unsupported. Women are pregnant and in terror from living with an abuser, without English as a first language, sometimes post-rape, pregnant through coercion, forced marriage, or as a result of sex trafficking. There are also teens, refugees and asylum-seekers, those living with intimate partner violence and those women made homeless, who are often incredibly isolated during this time.
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