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Costa FV, Silva AGE, Pedroso LA, Biancardi AL, Curi ALL. Bilateral acute depigmentation of the iris (BADI) and bilateral acute iris transillumination (BAIT): A case series from a center in Brazil. Arq Bras Oftalmol 2024; 87:e2023. [PMID: 38656031 DOI: 10.5935/0004-2749.2023-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/05/2023] [Indexed: 04/26/2024] Open
Abstract
Bilateral acute depigmentation of the iris and bilateral acute iris transillumination (BAIT) are similar clinical entities. The former causes acute-onset depigmentation of the iris stroma without transillumination, whereas the latter causes depigmentation of the iris pigment epithelium with transillumination. The etiopathogenesis of these conditions is not yet fully understood, but the proposed causes include the use of systemic antibiotics (especially moxifloxacin) and viral triggers. We present a case series of five female patients with a mean age of 41 (32-45) years, all of whom suffered acute onset of bilateral pain and redness of the eyes after moxifloxacin use (oral or topical). It is important for ophthalmologists to be aware of the two forms of iris depigmentation since this case series suggests that SARS-CoV-2 or its empirical treatment with moxifloxacin may trigger iris depigmentation. If this is the case, clinicians will likely see increased incidences of bilateral acute depigmentation of the iris and bilateral acute iris transillumination during and after the COVID-19 pandemic.
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Affiliation(s)
- Flavia Veiga Costa
- Laboratory of Infectious Diseases in Ophthalmology, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Amanda Gomes E Silva
- Laboratory of Infectious Diseases in Ophthalmology, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Leticia Alcântara Pedroso
- Laboratory of Infectious Diseases in Ophthalmology, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Ana Luiza Biancardi
- Laboratory of Infectious Diseases in Ophthalmology, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - André Luiz Land Curi
- Laboratory of Infectious Diseases in Ophthalmology, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Carvalho EM, Medeiros M, Veloso VG, Biancardi AL, Curi ALL. Monkeypox Infection Causing Conjunctival Vesicles and Anterior Uveitis. Ocul Immunol Inflamm 2024; 32:266-267. [PMID: 36800244 DOI: 10.1080/09273948.2023.2174884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/06/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023]
Abstract
Human monkeypox is a zoonosis caused by an orthopoxvirus and the clinical presentation resembles that of smallpox and chickenpox. The disease may start with a prodrome that includes lymphadenopathy, headache, fatigue, and fever, followed by a vesiculo-pustular rash. Ocular manifestations such as conjunctivitis and edema are present in approximately 20% of affected people, with a greater incidence among unvaccinated patients. Corneal involvement has also been reported and can result in corneal scarring and severe forms of keratitis. The natural course of the disease is most often benign and self-limiting, however, in some individuals, especially immunocompromised patients, there is a risk of complications such as bronchopneumonia, encephalitis, and vision loss. Herein, we present a case of a patient with monkeypox which caused conjunctival vesicles and anterior uveitis.
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Affiliation(s)
- Erika Moreira Carvalho
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Manuela Medeiros
- Infectious Diseases Department, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Ana Luiza Biancardi
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Abstract
PURPOSE To describe the most important cause of infectious posterior uveitis in pediatric patients. METHODS Review of the literature. RESULTS The most important causes of infectious uveitis in pediatric patients are: cat-scratch disease, toxocariasis, tuberculosis, viral diseases and toxoplasmosis. Ocular manifestations include retinitis, neuroretinitis, choroidal granulomas, peripheral granulomas and posterior pole granulomas. CONCLUSION Infectious posterior uveitis is a challenging subject and should be considered in the differential diagnosis of any posterior uveitis in children. Infectious uveitis must be excluded before initiating immunosuppressive therapy.
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Affiliation(s)
- André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Disease - INI/Fiocruz, Rio de Janeiro, Brazil
| | - Alejandra de-la-Torre
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Ariel Schlaen
- Department of Ophthalmology, Hospital Universitario Austral, Derqui-Pilar, Argentina
| | | | - Jyortimay Biswas
- Uveitis and Ocular Pathology Department, Sankara Nethralaya, Chennai, India
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Teixeira FHF, Santos NS, de Carvalho Mendes Paiva A, Carvalho EM, Biancardi AL, Curi ALL. Optical coherence tomography findings in fungal uveitis. Int Ophthalmol 2023; 43:3023-3030. [PMID: 37004606 DOI: 10.1007/s10792-023-02696-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/23/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE The purpose of the study was to describe the vitreal, retinal, and choroidal features of eyes affected by endogenous endophthalmitis (EE) and evaluate the effects of systemic antifungal drug treatment and pars plana vitrectomy by using spectral domain optical coherence tomography (SD-OCT). METHODS Medical records and SD-OCT images of eyes diagnosed with EE at a single uveitis tertiary referral center in Brazil were acquired at the time of diagnosis, after 7 days of high-dose antifungal drug treatment, and at follow-up assessments performed 30 days after resolution. RESULTS Thirteen eyes were enrolled in the study. All patients showed hyperreflective round-shaped lesions on SD-OCT and pre-retinal aggregates. Five eyes responded to antifungal systemic oral drugs despite showing vitreous opacity. The response to treatment was observable on optical coherence tomography (OCT) images. CONCLUSION Fungal endophthalmitis showed typical features on SD-OCT, facilitating early diagnosis and treatment despite the absence of vitreous culture or biopsy. This study suggests that OCT images can be used to support diagnosis by physicians who do not have access to vitreoretinal surgery.
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Affiliation(s)
- Fernando Henrique Flores Teixeira
- Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil.
| | - Nathalia Silva Santos
- Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil
| | - Alexandre de Carvalho Mendes Paiva
- Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil
| | - Erika Moreira Carvalho
- Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil
| | - Ana Luiza Biancardi
- Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil
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Pedroso LA, Costa FV, Silva AGE, Silva JRDMD, Biancardi AL, Curi ALL. Acute ocular toxoplasmosis presenting as a retinal angiomatous lesion. Arq Bras Oftalmol 2023; 86:294. [PMID: 37283376 DOI: 10.5935/0004-2749.2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/08/2023] Open
Affiliation(s)
- Leticia Alcântara Pedroso
- Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Flavia Veiga Costa
- Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Amanda Gomes E Silva
- Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Ana Luiza Biancardi
- Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - André Luiz Land Curi
- Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Mazzeo TJMM, Cristina Mendonça Freire R, Guimarães Machado C, Gomes AMV, Curi ALL. Vitreoretinal Surgery in Uveitis: From Old to New Concepts - A Review. Ocul Immunol Inflamm 2023:1-14. [PMID: 37093650 DOI: 10.1080/09273948.2023.2193842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
PURPOSE The aim of this article is to do a comprehensive literature review about the current role of pars plana vitrectomy in uveitis and in its different structural complications such as cystoid macular edema, epiretinal membrane, macular hole, and retinal detachment. METHODS This comprehensive literature review was performed based on a search on PubMed, BioMed Central, Science Open, and CORE databases, of relevant articles abording pars plana vitrectomy in uveitis. DISCUSSION Uveitis is a complex disease with multiple etiologies and pathogenic mechanisms. Therapeutic pars plana vitrectomy (PPV) may aid in uveitic structural complications such as cystoid macular edema, epiretinal membranes, macular hole, and retinal detachments even though some cases may present unpredictable visual outcomes. Diagnostic PPV with appropriate ancillary testing is also a valuable tool for the assessment and diagnosis of uveitis in a large proportion of patients. CONCLUSION Over the years, pars plana vitrectomy has undergone significant transformations since its invention nearly 5 decades ago, however, the quality of evidence in the literature regarding its use for uveitis has not improved in the same way. Even though some structural uveitis complications (as previously mentioned) may respond well to surgery, there is still a certain unpredictability regarding its visual outcomes. On the other hand, diagnostic vitrectomy with appropriate ancillary testing is also a valuable tool for the assessment and diagnosis of uveitis in a large proportion of patients.
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Affiliation(s)
| | | | - Cleide Guimarães Machado
- Retina and Vitreous Department, Suel Abujamra Institute, São Paulo, Brazil
- Retina and Vitreous Department, University of São Paulo (USP), São Paulo, Brazil
| | | | - André Luiz Land Curi
- Clinical Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases (INI - Fiocruz), Rio de Janeiro, Brazil
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Carvalho EM, Santos NS, Paiva ADCM, Teixeira FHF, Biancardi AL, Curi ALL. Presumed endogenous fungal endophthalmitis in a patient with lymphopenia and confirmed SARS-CoV-2 infection. Arq Bras Oftalmol 2023; 86:190-191. [PMID: 37132687 DOI: 10.5935/0004-2749.2022-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/01/2022] [Indexed: 05/04/2023] Open
Affiliation(s)
- Erika Moreira Carvalho
- Clinical Research Laboratory of Infectious Diseases in Ophthalmology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Nathalia Silva Santos
- Clinical Research Laboratory of Infectious Diseases in Ophthalmology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | | | - Ana Luiza Biancardi
- Clinical Research Laboratory of Infectious Diseases in Ophthalmology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - André Luiz Land Curi
- Clinical Research Laboratory of Infectious Diseases in Ophthalmology, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Giampietro BV, Dutra S, Oliveira RDVCD, Biancardi AL, Veloso V, Curi ALL. Ophthalmological Findings in Patients with SARS-CoV-2 Infection Examined at the National Institute of Infectious Diseases - INI/Fiocruz. Ocul Immunol Inflamm 2023; 31:44-47. [PMID: 34648392 DOI: 10.1080/09273948.2021.1980812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To describe the clinical characteristics, severity, and ophthalmological changes in SARS-CoV-2 patients through ophthalmological examinations performed at the reference center of the National Institute of Infectious Diseases, Brazil. METHODS This cross-sectional study assessed the examination results of SARS-CoV-2 patients from July 2020 to November 2020. In total, 150 patients were included and allocated into three groups of 50 patients depending on the disease severity. Group 1 patients were in the intensive care unit (ICU), group 2 patients were in the semi-ICU, and group 3 patients were outpatients. RESULTS Ten (6.7%) patients exhibited ophthalmological changes; five (10%), four (8%), and one (2%) patients in groups 1, 2, and 3, respectively. Ophthalmological findings included candle flame hemorrhage and cotton wool exudates. We analyzed the general characteristics of the 10 patients with ophthalmological changes. Nine were hospitalized and one was seen on an outpatient basis. CONCLUSION We observed ophthalmic changes in patients with SARS-CoV-2 infection, despite the absence of any clinical or laboratory risk factors indicative of such changes.
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Affiliation(s)
- Bárbara Vilela Giampietro
- Clinical Research in Infectious Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Sulamita Dutra
- Clinical Research in Infectious Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Ana Luiza Biancardi
- Clinical Research in Infectious Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Valdiléa Veloso
- Clinical Research in Std and Aids, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Clinical Research in Infectious Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Fichman V, Freitas DFS, do Valle ACF, de Souza RV, Curi ALL, Valete-Rosalino CM, de Macedo PM, Varon AG, Figueiredo-Carvalho MHG, Almeida-Silva F, Zancopé-Oliveira RM, Oliveira RDVC, Almeida-Paes R, Gutierrez-Galhardo MC. Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission. J Fungi (Basel) 2022; 8:jof8050469. [PMID: 35628725 PMCID: PMC9144044 DOI: 10.3390/jof8050469] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 11/29/2022] Open
Abstract
Although rare, disseminated sporotrichosis is increasing in several countries. Despite its limiting toxic potential, amphotericin B is the only intravenous antifungal available to treat severe sporotrichosis. We aimed to describe the effectiveness and safety of amphotericin B treatment for severe sporotrichosis. Clinical records of patients with disseminated sporotrichosis at a reference center were reviewed. This study included 73 patients. Most (53.4%) were men and non-white. HIV coinfection was the main comorbidity (52.1%). Most reported contact with cats (76.7%). Sporothrix brasiliensis was the causative species. Affected sites were skin (98.6%), osteoarticular system (64.4%), upper airway (42.5%), central nervous system (20.5%), eyes (12.3%), and lungs (8.2%). Median doses of amphotericin B used were 750 mg and 4500 mg for deoxycholate and lipid complex formulations, respectively. Amphotericin B discontinuation occurred in 20.5% due to adverse events, mainly azotemia. The outcomes included cure (52.1%), death due to sporotrichosis (21.9%), death due to other causes (9.6%), and loss to follow-up (8.2%). Survival analysis showed an association between cure and the absence of bone, upper airway, and central nervous system involvement. Amphotericin B is the first-choice treatment for disseminated sporotrichosis; however, the severity of systemic dissemination might predict its response. Favorable clinical results depend on prompt diagnosis, investigation of fungal dissemination, and early therapy initiation.
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Affiliation(s)
- Vivian Fichman
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil; (V.F.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.)
| | - Dayvison Francis Saraiva Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil; (V.F.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.)
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil; (V.F.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.)
| | - Rogerio Valls de Souza
- Medical Service, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (R.V.d.S.); (A.G.V.)
| | - André Luiz Land Curi
- Laboratory of Clinical Research in Infectious Ophthalmology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil;
| | - Cláudia Maria Valete-Rosalino
- Laboratory of Clinical Research and Surveillance in Leishmaniasis, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil;
| | - Priscila Marques de Macedo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil; (V.F.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.)
| | - Andréa Gina Varon
- Medical Service, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (R.V.d.S.); (A.G.V.)
| | - Maria Helena Galdino Figueiredo-Carvalho
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (M.H.G.F.-C.); (F.A.-S.); (R.M.Z.-O.); (R.A.-P.)
| | - Fernando Almeida-Silva
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (M.H.G.F.-C.); (F.A.-S.); (R.M.Z.-O.); (R.A.-P.)
| | - Rosely Maria Zancopé-Oliveira
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (M.H.G.F.-C.); (F.A.-S.); (R.M.Z.-O.); (R.A.-P.)
| | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (M.H.G.F.-C.); (F.A.-S.); (R.M.Z.-O.); (R.A.-P.)
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Fiocruz. Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil; (V.F.); (D.F.S.F.); (A.C.F.d.V.); (P.M.d.M.)
- Correspondence: ; Tel.: +55-21-3865-9578
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Carvalho EM, Teixeira FHF, de Carvalho Mendes Paiva A, Santos NS, Biancardi AL, Curi ALL. Bilateral Ampiginous Choroiditis following Confirmed SARS-CoV-2 Infection. Ocul Immunol Inflamm 2022; 31:843-846. [PMID: 35404726 DOI: 10.1080/09273948.2022.2049317] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Ampiginous Choroiditis is a rare posterior uveitis that combines clinical features of Acute Multifocal Posterior Placoid Pigment Epitheliopathy and Serpiginous Chorioretinitis. Its pathophysiology is poorly understood and further studies are necessary to understand which mechanisms start the immunologic reaction. CASE REPORT The purpose of this article is to report a well-documented case of Ampiginous Choroiditis following in seven days a RT-PCR confirmed SARS-CoV-2 infection, suggesting that the infection might have contributed as a trigger. CONCLUSION Timely diagnosis and correct treatment are paramount to improve the visual outcomes, and the patient had successful response to systemic steroids.
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Affiliation(s)
- Erika Moreira Carvalho
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Nathalia Silva Santos
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ana Luiza Biancardi
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Pichi F, Curi ALL, Vasconcelos-Santos DV, Marchese A, Cicinelli MV, Miserocchi E, Schlaen A. Optical Coherence Tomography Findings in Infectious Posterior Uveitis. Ocul Immunol Inflamm 2022; 30:652-663. [PMID: 35226572 DOI: 10.1080/09273948.2022.2032197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe and illustrate the main optical coherence tomography (OCT) findings of infectious uveitis. METHODS Narrative review. RESULTS Posterior segment OCT in patients with infectious uveitis reveals posterior hyaloid face precipitates, superficial retinal precipitates and infiltrates, foveolitis, retinitis, neuro-retinitis, choroidal granulomas, and choroiditis as main imaging biomarkers. Some of these features are specific to the underlying causing etiology and may support the diagnosis and the initiation of treatment. Some OCT features disappear completely with resolution; some others are associated with irreversible retinal damage. CONCLUSIONS OCT identifies different features of infectious uveitis into the vitreous, the retina, and the choroid. OCT characteristics, combined with other multimodal imaging features, are helpful in the differential diagnosis of infectious uveitis, the early detection of complications, and the assessment of the response to therapy.
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Affiliation(s)
- Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases - Ini - Fiocruz, Rio de Janeiro, Brazil
| | - Daniel Vitor Vasconcelos-Santos
- Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alessandro Marchese
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisabetta Miserocchi
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Ariel Schlaen
- Department of Ophthalmology, Hospital Universitario Austral, Derqui-Pilar, Argentina
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Paiva ADCM, Teixeira FHF, Carvalho EM, Santos NS, Biancardi AL, Curi ALL. An atypical early-onset X-linked retinoschisis mimicking uveitis masquerade syndrome. Arq Bras Oftalmol 2022; 85:322-323. [DOI: 10.5935/0004-2749.202200103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/02/2022] [Indexed: 11/20/2022] Open
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Teixeira FHF, Biancardi AL, Vieira MGC, Alves J, Tavares N, Moreira PP, Curi ALL. Community-acquired pseudomonas keratitis: an unusual presentation in a 2-month old infant that led to corneal transplant. Arq Bras Oftalmol 2022; 85:200-201. [DOI: 10.5935/0004-2749.20220091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 11/20/2022] Open
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Bastos MO, da Silva MST, Mesquita MB, Ferreira LCF, D‘ávila Freitas A, Gonçalves MLC, Nunes EP, de Lima MASD, Curi ALL, Biancardi AL. INFECÇÕES OPORTUNISTAS COM ACOMETIMENTO OCULAR NA AIDS: DESAFIOS DIAGNÓSTICOS. Braz J Infect Dis 2022. [DOI: 10.1016/j.bjid.2021.101847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Biancardi AL, Moraes RLD, Curi ALL. Indocyanine green angiographic findings in a patient with AIDS and disseminated sporotrichosis. Arq Bras Oftalmol 2022; 85:320-321. [DOI: 10.5935/0004-2749.202200102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/02/2022] [Indexed: 11/20/2022] Open
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Bastos MO, da Silva ABP, Curi ALL, Lamas CDC. PIOMIOSITE E ENDOFTALMITE: QUANDO UMA BACTÉRIA EXPLICA TUDO. Braz J Infect Dis 2022. [DOI: 10.1016/j.bjid.2021.101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Teixeira FHF, Paiva ADCM, Carvalho EM, Santos NS, Biancardi AL, Curi ALL. An unusual case of presumed cytomegalovirus: retinitis in a non-HIV patient treated for IgG 4-related disease. Arq Bras Oftalmol 2022; 85:543-544. [DOI: 10.5935/0004-2749.2022-0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/20/2022] Open
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Paiva ADCM, Biancardi AL, Curi ALL. Different clinical manifestations of ocular sporotrichosis in the same patient: an alert to ophthalmologists in nonendemic areas. Arq Bras Oftalmol 2020; 83:457-458. [PMID: 33084826 DOI: 10.5935/0004-2749.20200107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Ana Luiza Biancardi
- Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - André Luiz Land Curi
- Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Mazzeo TJMM, Dos Santos Motta MM, Curi ALL. Diffuse unilateral subacute neuroretinitis: review article. J Ophthalmic Inflamm Infect 2019; 9:23. [PMID: 31883049 PMCID: PMC6934636 DOI: 10.1186/s12348-019-0191-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/26/2019] [Indexed: 11/10/2022] Open
Abstract
Diffuse unilateral subacute neuroretinitis (DUSN) is an ocular infectious disease that can lead to severe visual impairment and blindness. It usually occurs in healthy young individuals and depending on the stage of the disease, it may present as vitritis, multifocal gray-white lesions in the outer retina, and derangement of the retinal pigment epithelium, narrowing of the retinal vessels and optic atrophy. Parasites of different sizes and species have been proposed as the etiologic agent of DUSN, including Ancylostoma caninum, Toxocara canis, and others. Thus, it is hypothesized that different infectious worms may be considered as the likely cause of both an autoimmune and toxic form of nematode retinopathy. Because serologic testing is variable, the definitive diagnosis is made when clinical characteristics of DUSN are found in conjunction with an intraocular worm. Ancillary tests can assist in the differential diagnosis when the nematode cannot be visualized, such as fluorescein and indocyanine green angiography, electrophysiological tests, visual field studies, and more recently, optical coherence tomography angiography. Cases in which the worm can be identified, it is defined as confirmed DUSN, and eyes with the typical clinical features but without identification of the worm should be classified as presumed DUSN. In confirmed DUSN, the classic treatment is directly photocoagulation of the worm; however, it can only be visualized in 30% (to 40%) of cases. Treatment of presumed DUSN cases with high-dose oral albendazole has shown encouraging results. However, perhaps due to the disease’s rarity or its underdiagnosis, there are no studies comparing current treatment modalities in both presumed and confirmed DUSN. Due to the possibility of this disease being, in part, autoimmune nematode retinopathy, corticosteroids associated with both albendazole or laser therapy, could be in any way beneficial. Thus, further comparative studies are necessary to elucidate the best treatment for this potentially blinding disease.
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Affiliation(s)
- Thiago José Muniz Machado Mazzeo
- Ophthalmology Residency Program, Federal University of the State of Rio de Janeiro (UNIRIO), Gaffrée and Guinle University Hospital, Rio de Janeiro, Brazil.
| | - Mario Martins Dos Santos Motta
- Ophthalmology Department, Federal University of the State of Rio de Janeiro (UNIRIO), Gaffrée and Guinle University Hospital, Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Mazzeo TJMM, Sena NB, Motta MM, Curi ALL. Diffuse Unilateral Subacute Neuroretinitis Evolving With Submacular Granuloma. Ocul Immunol Inflamm 2019; 29:90-94. [PMID: 31647685 DOI: 10.1080/09273948.2019.1662921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
DUSN is an infectious ocular disease that can lead to severe visual impairment and blindness. It usually occurs in young healthy individuals and depending on the stage of the disease, clinical presentation may range from mild vitritis and multifocal gray-white lesions in outer retina to optic atrophy.Parasites of different sizes and species have been proposed as the etiological agent of this disease. Thus, it is hypothesized that different infectious worms may be considered as the likely cause of a both autoimmune and toxic form of nematode retinopathy.Most patients present with already severe visual impairment and in the later stages of the disease, where the likelihood of improvement is low, despite therapy. In cases of early diagnosis, prompt treatment, whether with oral antihelmintic or direct photocoagulation of the worm, patients may show considerable visual improvement and have a more favorable prognosis.
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Affiliation(s)
- Thiago José Muniz Machado Mazzeo
- Ophthalmology Department, Federal University of the State of Rio de Janeiro (UNIRIO), Gaffrée and Guinle University Hospital, Rio de Janeiro, Brazil
| | - Nelson Batista Sena
- Ophthalmology Department, Federal University of the State of Rio de Janeiro (UNIRIO), Gaffrée and Guinle University Hospital, Rio de Janeiro, Brazil
| | - Mario Martins Motta
- Ophthalmology Department, Federal University of the State of Rio de Janeiro (UNIRIO), Gaffrée and Guinle University Hospital, Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Dutta Majumder P, Shah A, Madhuravasal Krishnan J, Rishi E, Curi ALL. Driving in Fog without Headlight: Management of a Challenging Case of Presumed Ocular Toxoplasmosis. Ocul Immunol Inflamm 2019; 29:115-117. [PMID: 31577475 DOI: 10.1080/09273948.2019.1657466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To describe a case of presumed ocular toxoplasmosis.Method: A retrospective chart review.Result: This case report describes a 35-year-old male who presented hypopyon anterior uveitis in his left eye. Fundus examination revealed severe vitritis which precluded the view of retina. His serum anti-toxoplasma immunoglobulin (Ig)G was significantly raised, with a normal anti-toxoplasma IgM level and PCR from nested primers targeting B1 gene of Toxoplasma gondii was positive. He was started on empirical anti-toxoplasma therapy. Undiluted vitreous specimen collected during lensectomy and diagnostic vitrectomy in left eye was also positive for nested primers targeting B1 gene of T. gondii.Conclusion: Ocular toxoplasmosis without retinochoroiditis, though extremely rare, can occur.
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Affiliation(s)
| | - Amravi Shah
- Department of Uvea, Sankara Nethralaya, Chennai, India
| | | | - Ekta Rishi
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
| | - André Luiz Land Curi
- ChefeLaPClinOftalmo, Instituto Nacional de Infectologia - INI - Fiocruz, Rio De Janeiro, Brazil
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Abstract
PURPOSE To describe a case of Acute Zika infection with ocular involvementMethods: Review of clinical recordsResults: Patient presented with sudden blurred vision in both eyes during an acute episode of zika virus infection. Ophthalmological examination revealed clinical picture of multifocal choroiditis in both eyes. Lesions improved and visual acuities returned to normal level without any treatment.Conclusion: Ocular changes in acute Zika virus infection is a rare condition. Patiens may present spontaneous recovery.
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Affiliation(s)
- Paulo Jimenez
- Department of Ophthalmology, Centro Oftalmologico de Ipanema/Oftalmoclinica Sao Goncalo , Rio de Janeiro, Brazil
| | - Eduardo Kestelman
- Department of Ophthalmology, Oftalmoclinica Sao Goncalo , São Gonçalo, Brazil
| | - Bernardo Kestelman
- Department of Ophthalmology, Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo , São Paulo, Brazil
| | - Alexandre Gomes Vizzoni
- Department of Infectious Disease, National Institute of Infectious Diseases Evandro Chagas- INI/Fiocruz , Rio de Janeiro, Brazil
| | - José Cerbino-Neto
- Department of Infectious Disease, National Institute of Infectious Diseases Evandro Chagas- INI/Fiocruz , Rio de Janeiro, Brazil
| | - André Luiz Land Curi
- Clinical Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases Evandro Chagas - INI/Fiocruz , Rio de Janeiro, Brazil
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Arinelli A, Aleixo ALQDC, Freitas DFS, do Valle ACF, Almeida-Paes R, Gutierrez-Galhardo MC, Curi ALL. Ocular Sporotrichosis: 26 Cases with Bulbar Involvement in a Hyperendemic Area of Zoonotic Transmission. Ocul Immunol Inflamm 2019; 28:764-771. [PMID: 31411512 DOI: 10.1080/09273948.2019.1624779] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To describe 26 cases of bulbar conjunctival sporotrichosis. METHODS Review of clinical records of patients with bulbar conjunctivitis due to culture-proven Sporothrix spp. infection, in Rio de Janeiro, from 2007 to 2017. RESULTS Twenty-six patients were identified. Median age was 25 years. Adults were more affected (53.8%), followed by adolescents (26.9%). There was a predominance of women (73.1%). Twenty-four patients (96%) reported contact with cats with sporotrichosis. Twenty-one patients (80.8%) presented a primary ocular sporotrichosis. Five patients presented associated eyelid lesions, and 21 (80.8%) tarsal conjunctivitis. Parinaud oculoglandular syndrome was observed in 17 (81%) patients. Eight patients (36.4%) reported the use of steroid drops before diagnosis was made. All patients but one were treated with oral itraconazole. Twenty-three patients (88.5%) were completely cured and three (11.5%) were lost to follow-up. Eight patients (34.8%) developed ocular sequelae. CONCLUSION Bulbar conjunctivitis is an important clinical presentation of ocular sporotrichosis. It can lead to ocular sequelae. Sporotrichosis should be considered in the differential diagnosis of ophthalmic external diseases, especially in patients with cat contact history.
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Affiliation(s)
- Andrea Arinelli
- Laboratory of Clinical Research in Infectious Ophthalmology, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
| | | | | | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, at Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
| | | | - André Luiz Land Curi
- Laboratory of Clinical Research in Infectious Ophthalmology, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
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Guaraldo L, Villar BBDLF, Durão NMG, Louro VC, Quintana MDSB, Curi ALL, Neves ES. Ocular toxoplasmosis: adverse reactions to treatment in a Brazilian cohort. Trans R Soc Trop Med Hyg 2019; 112:188-192. [PMID: 29788193 DOI: 10.1093/trstmh/try040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 04/20/2018] [Indexed: 01/09/2023] Open
Abstract
Background The purpose of this study was to estimate the frequency and describe the adverse drug reactions (ADRs) associated with the classic treatment of ocular toxoplasmosis (OT), namely sulfadiazine, pyrimethamine, corticosteroids and folinic acid. Methods We performed a descriptive study of a prospective cohort of patients with OT treated with the classic therapy. Data were collected during medical consultations and treatment. Results Of the 147 patients studied, 85% developed one or more ADR. Women presented more ADRs than men (95% vs 77%). Of the total reactions (n=394), 82% were mild, but we found one life-threatening event (Stevens-Johnson syndrome). The most frequent types (71%) of ADRs were gastrointestinal, skin and neurological or psychiatric. The majority of ADRs (90.3%) occurred before the second week of treatment. A third of the patients were treated for the ADR and 10% dropped out of OT treatment. Most (70%) of the ADRs were characterized as being probably caused by the drugs and may be associated with prednisone, sulfadiazine and sulfadiazine/prednisone. Six percent of ADRs were not previously described, such as taste alteration, constipation/bloating, dyspnoea, sweating and somnolence. Conclusions Our results suggest a high rate of ADRs to OT classic treatment, which requires careful follow-up in order to identify and treat ADRs early.
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Affiliation(s)
- Lusiele Guaraldo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil
| | | | - Nicolle Marins Gomes Durão
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil
| | - Virgínia Clare Louro
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil
| | - Marcel de Souza Borges Quintana
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil
| | - André Luiz Land Curi
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil
| | - Elizabeth Souza Neves
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil
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Aleixo ALQDC, Vasconcelos C. de Oliveira R, Cavalcanti Albuquerque M, Biancardi AL, Land Curi AL, Israel Benchimol E, Reis Amendoeira MR. Toxoplasmic retinochoroiditis: The influence of age, number of retinochoroidal lesions and genetic polymorphism for IFN-γ +874 T/A as risk factors for recurrence in a survival analysis. PLoS One 2019; 14:e0211627. [PMID: 30753197 PMCID: PMC6372150 DOI: 10.1371/journal.pone.0211627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023] Open
Abstract
Purpose To analyze risk factors for recurrent toxoplasmic retinochoroiditis. Design Single center prospective case series. Population and Methods A total of 230 patients with toxoplasmic retinochoroiditis were prospectively followed to assess recurrences. All patients were treated with a specific drug regime for toxoplasmosis in each episode of active retinochoroiditis. Individuals with chronic diseases and pregnant women were excluded. Survival analysis by extended Cox regression model (Prentice-Williams-Peterson counting process model) was performed to evaluate the time between recurrences according to some potential risk factors: age, number of retinochoroidal lesions at initial evaluation, sex and interferon gamma +874 T/A gene polymorphism. Hazard Ratios (HR) and 95% confidence intervals (CI) were provided to interpret the risk effects. Results One hundred sixty-two recurrence episodes were observed in 104 (45.2%) patients during follow-up that lasted from 269 to 1976 days. Mean age at presentation was 32.8 years (Standard deviation = 11.38). The risk of recurrence during follow up was influenced by age (HR = 1.02, 95% CI = 1.01–1.04) and number of retinochoroidal lesions at the beginning of the study (HR = 1.60, 95% CI = 1.07–2.40). Heterozygosis for IFN-γ gene polymorphism at position +874 T/A was also associated with recurrence (HR = 1.49, 95% CI = 1.04–2.14). Conclusion The risk of ocular toxoplasmosis recurrence after an active episode increased with age and was significantly higher in individuals with primary lesions, which suggests that individuals with this characteristic and the elderly could benefit from recurrence prophylactic strategies with antimicrobials. Results suggest an association between IFN-γ gene polymorphism at position +874T/A and recurrence.
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Affiliation(s)
| | | | | | | | - André Luiz Land Curi
- Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases—FIOCRUZ, Rio de Janeiro, Brazil
| | - Eliezer Israel Benchimol
- Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases—FIOCRUZ, Rio de Janeiro, Brazil
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Francesconi G, Francesconi do Valle AC, Passos SL, de Lima Barros MB, de Almeida Paes R, Curi ALL, Liporage J, Porto CF, Galhardo MCG. Comparative Study of 250 mg/day Terbinafine and 100 mg/day Itraconazole for the Treatment of Cutaneous Sporotrichosis. Mycopathologia 2010; 171:349-54. [DOI: 10.1007/s11046-010-9380-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 11/03/2010] [Indexed: 10/18/2022]
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Machado Od ODO, Gonçalves R, Fernandes EM, Campos WR, Oréfice F, Curi ALL. Bilateral Aspergillus endophthalmitis in a patient with chronic lymphocytic leukaemia. Br J Ophthalmol 2004; 87:1429-30. [PMID: 14609855 PMCID: PMC1771895 DOI: 10.1136/bjo.87.11.1429] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- M L R Monteiro
- Department of Ophthalmology, Hospital das Clínicas of the University of São Paulo Medical School, Brazil.
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