Bacterial corneal ulcers, causes of prolonged course, tactics of treatment

Kovaleva, L. A.; Krichevskaya, G. I.; Balackaya, N.V.

doi:10.25276/2410-1257-2018-4-51-53

Cited by 2 publications

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“…С целью выявления роли герпесвирусных инфекций в развитии затяжного течения бактериальной язвы роговицы кровь (n = 117) и соскобы с роговицы (n = 117) исследовали в полимеразной цепной реакции (ПЦР) на наличие геномов вируса простого герпеса 1-го типа (ВПГ 1), вируса простого герпеса 2-го типа (ВГЧ 2), вируса Эпштейна -Барр (ВЭБ), вируса герпеса человека 6-го (ВГЧ-6) и 7-го типа (ВГЧ-7). Использовали 2 варианта ПЦР: гнездовую ПЦР (nested PCR) и ПЦР в режиме реального времени (Real-timePCR) [12][13][14].…”

Section: пациенты и методыunclassified

“…У пациентов с центральной бактериальной язвой роговицы, сочетающейся с положительными результатами лабораторного исследования на ВГЧ, после полного купирования гнойного воспалительного процесса площадь поверхности язвы не сокращалась, эпителизация отсутствовала. На основании полученных результатов мы сочли целесообразным включить в комплекс лечения БЯР противовирусную терапию (ПВТ): глазные капли Дифенгидрамин + Интерферон альфа-2а 4 раза в сутки, глазную мазь Ацикловир 3 раза в сутки до завершения эпителизации ЯР; системно -внутрь Ацикловир или Валацикловир 1000 мг в сутки в течение 5-10 дней [12][13][14].…”

Section: результаты и обсуждениеunclassified

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Clinical Aspects of Bacterial Corneal Ulcer Prolonged Course, the Role of Herpes Viruses in Its Pathogenesis, Treatment

et al. 2019

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Purpose: to study the role of human herpesviruses (HHV) in the pathogenesis of prolonged bacterial corneal ulcers. Patients and methods. 117 patients with bacterial corneal ulcer were examined. Two groups were identified: a favorable course-with duration of bacterial corneal ulcer epithelialization for 17 days (62 people) and a prolonged course with a persistent ulcer more than 17 days (55 people). Blood samples (n = 117) and scrapes from corneal ulcer (n = 117) were investigated in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Herpes simplex virus (HSV1, 2), Epstein-Barr virus (EBV), Human herpesvirus type 6, 7 (HHV-6, HSV-7). Results. The HSV1, 2 and EBV genomes were detected in the cornea significantly more often in BCU of prolonged course compared with a favorable course (HSV1, 2 p = 0.012; EBV p = 0.012), and HHV-6 was detected not only in the cornea (p = 0.000), but also and in blood (p = 0.007). In patients with HHV DNA in corneal scarps and/or blood, after resorption of purulent infiltrate, corneal epithelialization was absent, and the use of antiherpetic drugs allowed to reduce the completion time of BCU epithelialization. Conclusion. The role of HHV-6, EBV, HSV 1, 2 in the pathogenesis of bacterial corneal ulcer of protracted course was revealed. The expediency of examination of patients with bacterial corneal ulcer on HHV is shown, a method of treatment is proposed, including antiherpetic therapy, which makes it possible to prevent the development of a protracted course.

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Section: пациенты и методыunclassified

Section: результаты и обсуждениеunclassified

Clinical Aspects of Bacterial Corneal Ulcer Prolonged Course, the Role of Herpes Viruses in Its Pathogenesis, Treatment

et al. 2019

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Treatment of corneal ulcers and endophthalmitis caused by yeast fungi

Kovaleva

Krichevskaya

Исааковна³

et al. 2021

Russian Pediatric Ophthalmology

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Aim: To analyze the pathogenesis, clinical features, and treatment algorithm of fungal corneal ulcer with endophthalmitis to increase medical alertness and reduce the unjustified use of antibacterial and corticosteroid therapy in corneal diseases of various etiologies, leading to the development of secondary ophthalmomycosis. Results: The pathogenesis was analyzed, and the characteristic clinical symptoms of severe fungal corneal ulcer and endophthalmitis caused by Candida albicans were described. Intensive, long-term, unjustified antibacterial and corticosteroid therapy caused a prolonged course of herpetic corneal ulcer, as well as the addition of a secondary bacterial infection, and led to the development of severe corneal ulcer and fungal endophthalmitis in a 13-year-old child. Conclusion: The required maximum medical alertness and early, accurate clinical differential diagnosis between bacterial and fungal corneal ulcer, as well as the rapid flow of ophthalmomycosis and false-negative results of sowing content conjunctival sac entail expansion of the range and quantity of antibacterial drugs used in the absence of positive dynamics of antibiotic therapy and an increased frequency of secondary fungal infection. The clinical symptoms of a severe fungal corneal ulcer with endophthalmitis described in this report contribute to the early diagnosis of ophthalmomycosis before the type of pathogen is identified by laboratory methods, which makes it possible to start antifungal therapy earlier and avoid corneal perforation and eye loss. In most countries, due to the lack of an ocular form of antifungal drugs, for local treatment of corneal candidiasis, a 0.2% solution of fluconazole intended for intravenous administration is installed in the eyes.

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Bacterial corneal ulcers, causes of prolonged course, tactics of treatment

Cited by 2 publications

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Clinical Aspects of Bacterial Corneal Ulcer Prolonged Course, the Role of Herpes Viruses in Its Pathogenesis, Treatment

Clinical Aspects of Bacterial Corneal Ulcer Prolonged Course, the Role of Herpes Viruses in Its Pathogenesis, Treatment

Treatment of corneal ulcers and endophthalmitis caused by yeast fungi

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