We report a case of probable Zaire Ebola virus–related ophthalmologic complications in a physician from the United States who contracted Ebola virus disease in Liberia. Uveitis, immune activation, and nonspecific increase in antibody titers developed during convalescence. This case highlights immune phenomena that could complicate management of Ebola virus disease–related uveitis during convalescence.
Althouygh Menkes disease has well-recognized neurologic, developmental, and cutaneous features, the initial presentation may resemble child abuse. We describe a 5-month-old boy with multiple fractures indicative of nonaccidental trauma who was ultimately diagnosed with Menkes disease. Copper deficiency leads to connective tissue abnormalities and may result in subdural hematomas, wormian bones, cervical spine defects, rib fractures, and spurring of the long bone metaphyses. Several of these findings, including fractures and subdural hematomas, may be misinterpreted as child abuse.
Patch testing is the standard of care for diagnosing cutaneous allergic contact dermatitis (ACD) of unknown etiology. 1 While the list of testable allergens is extensive and growing by the year, it is a small group of materials that cause the majority of ACD cases. 1 Nickel is by far the most frequently positive of the patch-tested allergens, with rates around 17.5% in ACD patients. 2 Interestingly, individuals in the general population without previously diagnosed ACD can also test positive to patch-tested allergens, indicating previously unknown sensitivities. 3 In fact, one population study out of Norway found positive patch tests in about 35% of women and 15% of men in the general population, with nickel again representing the majority of reactions. 3 The possibility of undiagnosed or subclinical allergies is the basis for patch testing prior to certain surgical procedures, especially cardiovascular, gynecologic, orthopedic, and others in which foreign body implants are placed. Patch testing has been utilized for years as a screening tool prior to orthopedic joint replacement procedures to avoid allergic complications such as cutaneous reactions, edema, and implant failure. 4 Rather than routine patch testing for all patients, however, generally only those individuals with a history of metal allergy are recommended to be patch tested before orthopedic implant surgery. 5 Interestingly, this recommendation was made
This report describes a 19-year-old patient with the rare association of macular retinoschisis and outer retinal hole formation with papillorenal syndrome. Initially diagnosed with transplant-related central serous chorioretinopathy, she presented several years later with worsening vision and distortion in her right eye. On examination, she was found to have bilateral optic nerve dysplasia, bilateral macular and extramacular retinoschisis, and a serous retinal detachment with outer hole formation in the right eye. A history of prior renal transplantation due to poor kidney development led to the diagnosis of papillorenal syndrome.
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