Diagnostic and Therapeutic Challenges in Ocular Histoplasmosis – A Case Report

Kawali, Ankush; Mahendradas, Padmamalini; Sanjay, Srinivasan; Prathima, K. M.; Yadav, Jaydev; Panchagnula, Renuka; Sathish, K S

doi:10.1080/09273948.2020.1797114

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…Earlier we have used confocal microscopy to differentiate infectious from non infectious uveitis. 18 Confocal microscopy revealed yeast like structure in both cases and with hyphae and cyst in second case which is similar to earlier reports suggestive of fungal etiology 19,20,21 Subsequently our observation was con rmed my molecular diagnostic test in both the cases, fungal culture in one case and Histopathological examination (HPE) from the exudates in anterior chamber in the second case. In the rst case infection was due to Candida Tropicalis and in the second case, we could demonstrate the fungal hyphae both in confocal microscopy and also on HPE examination from the anterior chamber exudates.…”

Section: Casesupporting

confidence: 86%

In Vivo Confocal Microscopy Features In Post COVID19 Fungal Endophthalmitis In Type 2 Diabetes

Mahendradas

Sanjay

Shettiagar

et al. 2021

Preprint

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Introduction: Corona virus disease-19 (COVID-19) infection with aggressive treatment has resulted in immunosuppression, and co-existing comorbidities that have made patients vulnerable to secondary infections including fungal infections. Purpose: We describe the clinical presentation, various diagnostic methods including in-vivo confocal microscopy features, management and clinical outcomes in Post COVID-19 fungal endophthalmitis in type II diabetics. Methods: Prospective, interventional study on two patients who recovered from COVID-19 who developed endogenous endophthalmitis presented to a tertiary eye care centre in South India. Results: Fungal infection was diagnosed based on clinical features, confocal microscopy, molecular diagnostic methods and culture methods. Two patients were treated with topical, intravitreal and systemic antifungal therapy. Conclusion: We report for the first time two cases of post COVID-19 fungal endophthalmitis in two diabetic patients with confocal features. High index of suspicion, early diagnosis, and appropriate management can improve the visual outcome in post COVID-19 fungal endophthalmitis cases.

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Section: Casesupporting

confidence: 86%

In Vivo Confocal Microscopy Features In Post COVID19 Fungal Endophthalmitis In Type 2 Diabetes

Mahendradas

Sanjay

Shettiagar

et al. 2021

Preprint

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“…Media Haze [30] MH The opacity of media. Cataracts, vitreous opacities, corneal edema, or small pupils.…”

Section: Diabetic Retinopathy [28] Drmentioning

confidence: 99%

Multiple Ocular Disease Diagnosis Using Fundus Images Based on Multi-Label Deep Learning Classification

et al. 2022

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Designing computer-aided diagnosis (CAD) systems that can automatically detect ocular diseases (ODs) has become an active research field in the health domain. Although the human eye might have more than one OD simultaneously, most existing systems are designed to detect specific eye diseases. Therefore, it is crucial to develop new CAD systems that can detect multiple ODs simultaneously. This paper presents a novel multi-label convolutional neural network (ML-CNN) system based on ML classification (MLC) to diagnose various ODs from color fundus images. The proposed ML-CNN-based system consists of three main phases: the preprocessing phase, which includes normalization and augmentation using several transformation processes, the modeling phase, and the prediction phase. The proposed ML-CNN consists of three convolution (CONV) layers and one max pooling (MP) layer. Then, two CONV layers are performed, followed by one MP and dropout (DO). After that, one flatten layer is performed, followed by one fully connected (FC) layer. We added another DO once again, and finally, one FC layer with 45 nodes is performed. The system outputs the probabilities of all 45 diseases in each image. We validated the model by using cross-validation (CV) and measured the performance by five different metrics: accuracy (ACC), recall, precision, Dice similarity coefficient (DSC), and area under the curve (AUC). The results are 94.3%, 80%, 91.5%, 99%, and 96.7%, respectively. The comparisons with the existing built-in models, such as MobileNetV2, DenseNet201, SeResNext50, InceptionV3, and InceptionresNetv2, demonstrate the superiority of the proposed ML-CNN model.

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“…Systemic histoplasmosis is ubiquitous, and the causative fungus is found in the soil fertilized by birds, chicken, and bats. [ 1 2 3 4 ] Histoplasmosis is common in immunosuppressed individuals and may present with mild influenza, which often leads to granulomatous disease and can even progress to life-threatening disease. [ 1 2 3 4 ] In developing countries such as India, it can mimic tuberculosis.…”

mentioning

confidence: 99%

“…[ 1 2 3 4 ] Histoplasmosis is common in immunosuppressed individuals and may present with mild influenza, which often leads to granulomatous disease and can even progress to life-threatening disease. [ 1 2 3 4 ] In developing countries such as India, it can mimic tuberculosis. [ 3 4 ] Ocular manifestations of systemic histoplasmosis include retinitis, choroiditis, optic neuritis, uveitis, and endophthalmitis.…”

mentioning

confidence: 99%

“…[ 3 4 ] Ocular manifestations of systemic histoplasmosis include retinitis, choroiditis, optic neuritis, uveitis, and endophthalmitis. [ 1 2 3 4 ] Presumed ocular histoplasmosis syndrome (POHS) may present with peripheral retinal or choroidal involvement called “histo spots,” and they mostly have clear vitreous, unlike systemic histoplasmosis. [ 1 2 ] POHS is mostly immunologic.…”

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confidence: 99%

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Commentary: Ocular histoplasmosis and nocardiosis co-infection: A rare presentation

Das¹,

Bhattacharjee

Rehman

et al. 2022

Indian Journal of Ophthalmology

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Diagnostic and Therapeutic Challenges in Ocular Histoplasmosis – A Case Report

Cited by 7 publications

References 6 publications

In Vivo Confocal Microscopy Features In Post COVID19 Fungal Endophthalmitis In Type 2 Diabetes

In Vivo Confocal Microscopy Features In Post COVID19 Fungal Endophthalmitis In Type 2 Diabetes

Multiple Ocular Disease Diagnosis Using Fundus Images Based on Multi-Label Deep Learning Classification

Commentary: Ocular histoplasmosis and nocardiosis co-infection: A rare presentation

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