Esclerite infecciosa espontânea por Nocardia asteroides: relato de caso

Urbano, Andréia Peltier; Urbano, Alessandra Peltier; Torigoe, Andréa Mara Simões; Urbano, Ivan; Kara‐José, Newton

doi:10.1590/s0004-27492003000200020

Cited by 4 publications

(10 citation statements)

References 15 publications

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“…However, clinical observation showed that the right eye of patient 2 developed hypotony and blindness. The present findings are consistent with ocular complications in necrotizing scleritis in humans, which can lead to retinal detachment and phthisis bulbi in some cases (URBANO et al, 2003).…”

Section: Discussionsupporting

confidence: 90%

Diagnóstico ultrassonográfico e monitoramento da esclerite em cães

Sá

Perlmann

Góes

et al. 2014

Braz. J. Vet. Res. Anim. Sci.

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Scleritis is a severe painful inflammatory and vision-threatening disease. The purpose of this paper is to describe two cases of scleritis in dogs treated with immunosuppressors and monitored by ocular ultrasound. In both cases the ocular wall presented marked thickening and the ultrasonic exams were repeated for weeks showing progressive improvement allowing adjusting the dosage of the medications. In conclusion, ocular ultrasound is a useful tool in the diagnosis and management of scleritis in dogs.Keywords: Scleritis. Ultrasound. Dogs. ResumoA esclerite é uma doença inflamatória extremamente dolorosa e pode afetar seriamente a visão. O presente trabalho descreve dois casos de esclerite em cães tratados com imunossupressores e monitorados pela ultrassonografia ocular. Em ambos os casos, a parede ocular apresentava acentuado espessamento e as avaliações ultrassonográficas foram repetidas por semanas, revelando melhoria progressiva e permitindo ajustes na dosagem das medicações. Em conclusão, a ultrassonografia ocular é um instrumento útil no diagnóstico e tratamento da esclerite em cães.Palavras-chave: Esclerite. Ultrassom. Cães.

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Section: Discussionsupporting

confidence: 90%

Diagnóstico ultrassonográfico e monitoramento da esclerite em cães

Sá

Perlmann

Góes

et al. 2014

Braz. J. Vet. Res. Anim. Sci.

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“…One case of spontaneous Nocardia scleritis in a poorly controlled diabe-tic male patient without history of trauma or intraocular surgery has been reported (9) . Another case of spontaneous Nocardia scleritis has been reported in a patient without risk factors after a week with a history of manipulation of the soil (14) .…”

Section: Discussionmentioning

confidence: 98%

Necrotizing nocardial scleritis after combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation: a case report and review of the literature

Ramos-Esteban¹,

Servat²,

Silva³

et al. 2007

Arq. Bras. Oftalmol.

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We report the history and clinical presentation of an 88-year-old female with Fuchs dystrophy who developed an acute anterior necrotizing scleritis in her left eye 23 months after an uncomplicated combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation which progressed to slceral perforation with uveal prolapses. The patient underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis. Surgical specimens of the area of scleral perforation were sent for histology and microbiologic studies. Analysis of surgical specimens revealed the presence of culture-proven Nocardia asteroides as a causative agent for the patient's scleral perforation. Results of her systemic autoimmune work-up were not conclusive. Successful treatment with tectonic scleral reinforcement with donor corneal tissue and preserved pericardium, oral and topical trimethoprim-sulfamethoxazole and topical amikacin salvaged the globe and increased vision. The patient's final best-corrected visual acuity sixteen months after her last operation remains 20/70. Prompt surgical intervention with submission of appropriate specimens for pathological diagnosis and microbiology, along with consultation with rheumatologic and infectious disease specialists, are mandatory to minimize visual loss in cases of suspected infectious necrotizing scleritis.

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“…Clinically, nodular, multifocal scleral abscesses predominated (32%), 1 , 2 , 3 , 6 , 8 , 10 , 15 , 20 , 22 , 6 , 8 , 10 , 15 , 20 , 22 followed by ulcerative scleritis 1 , 7 , 13 , 18 , 19 , 21 , 23 , 24 and combinations thereof. 1 , 3 , 12 , 16 , 17 , 25 Four studies reported keratitis 1 , 2 , 7 , 14 ; one patient wore a soft contact lens. 14 The predisposing factors were, in decreasing order: prior ocular trauma (21/43), prior surgery (17/43), the use of steroids (7/43), and a previous corneal infection (2/43).…”

Section: Resultsmentioning

confidence: 99%

Nocardial scleritis: A case report and a suggested algorithm for disease management based on a literature review

Cunha

Juncal

Carvalhaes

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeTo report a case of nocardial scleritis and to propose a logical treatment algorithm based on a literature review.ObservationsIt is important to suspect a nocardial infection when evaluating anterior unilateral scleritis accompanied by multiple purulent or necrotic abscesses, especially in male patients with a history of chronic ocular pain and redness, trauma inflicted by organic materials, or recent ophthalmic surgery. A microbiological investigation is essential. In positive cases, a direct smear reveals weakly acid-fast organisms or Gram-positive, thin, beading and branching filaments. Also, the organism (usually) grows on blood agar and Lowenstein–Jensen plates. An infection can generally be fully resolved by debridement of necrotic areas and application of topical amikacin drops accompanied by systemic sulfamethoxazole–trimethoprim.Conclusions and significanceTogether with the case report described, we review data on a total of 43 eyes with nocardial scleritis. Our proposed algorithm may afford a useful understanding of this sight-threatening disease, facilitating easier and faster diagnosis and management.

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Esclerite infecciosa espontânea por Nocardia asteroides: relato de caso

Cited by 4 publications

References 15 publications

Diagnóstico ultrassonográfico e monitoramento da esclerite em cães

Diagnóstico ultrassonográfico e monitoramento da esclerite em cães

Necrotizing nocardial scleritis after combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation: a case report and review of the literature

Nocardial scleritis: A case report and a suggested algorithm for disease management based on a literature review

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