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Indian Journal of Ophthalmology Sep 2023Ophthalmic dirofilariasis is an uncommon zoonotic parasitic infection caused by species of Dirofilaria, a dog tapeworm that is transmitted to human by mosquitoes. Man is...
BACKGROUND
Ophthalmic dirofilariasis is an uncommon zoonotic parasitic infection caused by species of Dirofilaria, a dog tapeworm that is transmitted to human by mosquitoes. Man is a dead-end host for the parasite. Ophthalmic involvement is rare and includes periorbital, subconjunctival, subtenon, and intra-ocular involvement. We report the removal of a subconjunctival worm and identification by light microscopy (LM) and scanning electron microscopy (SEM).
PURPOSE
: A 62-year-old female presented with complaints of redness, discharge, and foreign body sensation with difficulty in opening eyes in the left eye for the last 3 days. The patient is a non-vegetarian. On examination, her best corrected visual acuity in both eyes was 20/20. On slit lamp examination, there was a long, thin, round, coiled white subconjunctival live worm in the left eye superiorly. The rest of anterior segment evaluation, intra-ocular pressure, and fundus was normal in both eyes. The parasite was removed under local anesthesia from subconjunctival space [Video]. External surface morphology under LM revealed fine transverse cuticular striations with tapered cephalic and caudal ends. Uterus was long and coiled with indistinguishable masses inside. The finding was also confirmed by SEM.
SYNOPSIS
A subconjuctival parasite was removed and identified as Dirofilaria repens by characteristic LM and SEM findings.
HIGHLIGHT
Dirofilaria species may lodge in many tissues of human bodies including eye and adnexa. Dirofilaria is a natural parasite of carnivorous animals, mostly dogs, cats, and foxes. The most common mode of transmission to human is usually by bite of mosquitoes like Culex and Aedes, which are considered as vectors, and it is often thought that parasitemia is because of accidental conduction. Simple surgical removal of the worm is curative. After removal, the worm should be visualized directly under LM. All the internal structures of the transparent worm could be seen and compared with those under SEM.
Topics: Humans; Female; Male; Animals; Dogs; Middle Aged; Microscopy, Electron, Scanning; Parasites; Mosquito Vectors; Eye; Face
PubMed: 37602631
DOI: 10.4103/IJO.IJO_830_23 -
Case Reports in Ophthalmology 2023Orbital cellulitis is a serious, life-threatening infection, typically in paediatric patients, and its bilateral presentation in adults is atypic. We present an unusual...
Orbital cellulitis is a serious, life-threatening infection, typically in paediatric patients, and its bilateral presentation in adults is atypic. We present an unusual bilateral manifestation of orbital cellulitis and abscess, caused by Enterococci in an adult patient. is an extremely rare cause of orbital inflammation and we found three published case reports only, all of which are unilateral and seen in children. A 51-year-old male presented with 1-week history of pyrexia, painful proptosis, periorbital swelling, and low vision of both eyes. He was diagnosed with bilateral orbital cellulitis and was treated with empiric antibiotic medication for 8 days, but symptoms persisted. MRI showed bilateral intra- and extraconal fluid-intensity collections. Microbiology was taken from the orbit and revealed invasion. Pus collections were drained for 1 week. Systemic and intraorbital antibiotics were administered. The patient recovered and vision returned to normal. This is a rare case of bilateral orbital cellulitis and abscesses with invasive infection. infection of the orbit is unusual and should be considered, especially if patient does not respond to empiric antibiotic therapies.
PubMed: 37901623
DOI: 10.1159/000533608 -
Annals of Plastic Surgery Apr 2024Loss of vision and other ocular defects are a concern with eyelid burn sequelae. This most commonly progresses from eyelid contracture to cicatricial ectropion and...
BACKGROUND
Loss of vision and other ocular defects are a concern with eyelid burn sequelae. This most commonly progresses from eyelid contracture to cicatricial ectropion and lagophthalmos. When left untreated, these may lead to exposure keratitis, ulceration, infection, perforation, and loss of vision. In the case of full-thickness eyelid burns, release and grafting are required. However, there is a paucity of studies on outcomes in eyelid burn surgery treatment, despite concern for permanent ocular damage or loss of vision. The aim of the study is to describe the complication rates in burn eyelid reconstruction at a single center for 14 years.
METHODS
A retrospective cohort study was performed of all patients who had sustained eyelid burns and required reconstruction between April 2009 and February 2023. Medical records were obtained from patients' charts. Collected data include demographics, medical history, type of injury, indication for surgery, procedure performed, and complications.
RESULTS
A total of 14 patients and 25 eyelids underwent eyelid reconstruction of the 901 total patients with burn-related injuries requiring plastic surgery reconstruction. These patients underwent 54 eyelid surgeries with a mean follow-up time of 13.1 ± 17.1 months. Patients were 71% men and 29% women, with a mean age of 45.1 ± 15.6 years. In 53.7% (n = 29) of the cases, the simultaneous reconstruction of both the upper and lower eyelids was necessary. The reconstruction of the upper and lower eyelid alone represented a smaller percentage (25.9% and 20.4%, respectively). On average, the patients received 3.9 ± 3.5 eyelid surgeries. The overall complication rate was 53.7% (n = 29). The most common complication was ectropion (42.6%, n = 23). Other complications included eye injury (25.9%, n = 14), lagophthalmos (24.1%, n = 13), local infection (7.4%, n = 4), and graft loss (5.6%, n = 3).
CONCLUSION
Periorbital burns represent a major challenge that may require complex surgical intervention. Full-thickness skin graft remains the standard of care for patients with eyelid burns. However, there is a high incidence of ectropion that may require reoperation. Further studies examining the conditions of successful eyelid burn procedures may provide guidance on when patients may benefit from eyelid reconstruction during their burn treatment.
Topics: Male; Humans; Female; Adult; Middle Aged; Ectropion; Retrospective Studies; Lagophthalmos; Surgery, Plastic; Eyelids; Burns
PubMed: 38556664
DOI: 10.1097/SAP.0000000000003848 -
Orbit (Amsterdam, Netherlands) Aug 2023A 61-year-old man with no significant past medical history presented to a quaternary ophthalmic referral center with acute right-sided medial canthal pain, periorbital... (Review)
Review
A 61-year-old man with no significant past medical history presented to a quaternary ophthalmic referral center with acute right-sided medial canthal pain, periorbital edema, and erythema despite oral antibiotic therapy. CT imaging confirmed the presence of right preseptal cellulitis and lacrimal sac aspiration identified . A diagnosis of acute right-sided dacryocystitis with preseptal cellulitis was made. He was successfully treated with broadening of antibiotic therapy to intravenous meropenem. Symptomatic resolution was noted on follow-up without evidence of disease recurrence. This unusual case of dacryocystitis and preseptal cellulitis highlights the increasing prevalence and challenges of treating these uncommon organisms.
Topics: Male; Humans; Middle Aged; Cellulitis; Enterobacter cloacae; Dacryocystitis; Anti-Bacterial Agents; Lacrimal Apparatus; Eyelid Diseases
PubMed: 35075984
DOI: 10.1080/01676830.2022.2026417 -
Cureus Oct 2023Acute dacryocystitis and orbital cellulitis are conditions with serious implications, particularly among pediatric patients. The co-occurrence of these conditions in...
Acute dacryocystitis and orbital cellulitis are conditions with serious implications, particularly among pediatric patients. The co-occurrence of these conditions in children is rare, and their association with coronavirus disease 2019 (COVID-19) infection introduces a unique dimension. We present the case of a five-year-old boy who presented to the pediatric emergency department with left periorbital swelling, erythema, and excessive tearing. He had a history of low-grade fever and rhinorrhea, raising concerns about COVID-19. Upon physical examination, we observed significant periorbital swelling and erythema, accompanied by conjunctival injection and chemosis. The diagnosis encompassed acute dacryocystitis and cellulitis, with subsequent confirmation of COVID-19 through testing. Imaging confirmed the presence of post-septal cellulitis and ethmoid sinus opacification. The patient received intravenous antibiotics, leading to clinical improvement and eventual discharge for outpatient follow-up. This case underscores the importance of maintaining a high index of suspicion for unusual presentations in pediatric patients. Successful management involved a multidisciplinary approach, emphasizing the significance of promptly initiating antibiotic therapy and adopting conservative measures for nasolacrimal duct obstruction.
PubMed: 37933361
DOI: 10.7759/cureus.46559 -
Frontiers in Pediatrics 2023To report and review infantile orbital abscess caused by methicillin-resistant (MRSA).
OBJECTIVE
To report and review infantile orbital abscess caused by methicillin-resistant (MRSA).
METHODS
We report a case of MRSA-induced infantile orbital abscess accompanied by sepsis, pneumonia, and purulent meningitis. We systematically review cases of MRSA-induced infantile orbital abscess published in PubMed, Web of Science and ScienceDirect until April 2023.
RESULTS
We reviewed 14 patients [our patient + 13 patients (10 papers) identified via literature searches]. There were nine boys and five girls; nine neonates and five older infants; and 8 full-term births and 1 preterm birth. The gestational age at birth was unknown for five infants. The right and left orbits were affected in 10 and 4 patients, respectively. The clinical presentation included periorbital soft-tissue edema or redness (11 patients), fever (7 patients), exophthalmos (10 patients), limited eye movement (4 patients), purulent eye secretions (2 patients), and skin abscess and convulsion (1 patient each). The source of infection was sinusitis (8 patients), vertical transmission, gingivitis, dacryocystitis, upper respiratory tract infection (1 patient each), and unknown (2 patients). MRSA was detected in blood (6 patients) or pus culture (8 patients). Vancomycin or linezolid were used for 11 patients; corticosteroids were administered to only 1 patient. Surgical drainage was performed for 13 infants (external drainage, 11 patients; endoscopic drainage, 2 patients). Two patients initially had pulmonary and intracranial infections. Except for one patient with neurological dysfunction at discharge, all other infants had no sequelae or complications.
CONCLUSION
Early aggressive anti-infective treatment and timely drainage are essential for managing MRSA-induced infantile orbital abscess.
PubMed: 38188913
DOI: 10.3389/fped.2023.1272852 -
Ocular Immunology and Inflammation Sep 2023- complex is emerging as one of the most common causes of hospital-acquired infection globally. We present a case of orbital cellulitis caused by the complex. A... (Review)
Review
- complex is emerging as one of the most common causes of hospital-acquired infection globally. We present a case of orbital cellulitis caused by the complex. A 73-year-old Chinese woman with a history of rheumatoid arthritis presented with subacute onset of right upper eyelid swelling for 1 week. Computer tomography revealed a post-septal soft tissue lesion located at the right superior orbit that was enhanced with contrast, compressing on the superior aspect of the globe. Anterior orbitotomy with incisional biopsy of the right superior orbital lesion was performed, and histopathological examination was consistent with nonspecific inflammatory mass. The microbiological culture of the specimen yielded and complex, which was sensitive to ciprofloxacin, ampicillin, and gentamicin. The infection resolved after a 1-week course of intravenous augmentin. Ophthalmologists should be alert to the possibility of patients having and in periorbital cellulitis.
Topics: Female; Humans; Aged; Acinetobacter baumannii; Acinetobacter calcoaceticus; Orbital Cellulitis; Acinetobacter Infections; Orbit
PubMed: 36074653
DOI: 10.1080/09273948.2022.2103715 -
Acta Psychologica Sep 2023Facial aesthetics are of great importance in social interaction. With the widespread adoption of face masks in response to the Covid-19 pandemic, there is growing...
BACKGROUND
Facial aesthetics are of great importance in social interaction. With the widespread adoption of face masks in response to the Covid-19 pandemic, there is growing interest in understanding how wearing masks might impact perceptions of attractiveness, as they partially or completely conceal facial features that are typically associated with attractiveness.
OBJECTIVES
This study aimed to explore the impact of mask wearing on attractiveness and to investigate whether the color (red or blue) of the mask has any effect on the perception of a person's attractiveness, while also considering gender and age as contributing factors. Additionally, the study intended to evaluate gaze patterns, initial focus, and dwell time in response to masked and unmasked faces.
METHODS
30 AI-generated images of 15 female and 15 male faces were presented to 71 participants (35 male, 36 female) in 3 conditions: not wearing any mask, wearing a red surgical mask, and wearing a blue surgical mask. The perceived attractiveness was rated on an ordinal scale of 1-10 (10 being most attractive). Gaze behavior, dwell time and initial focus were recorded using a stationary eye-tracking system.
RESULTS
The study found that wearing masks had no significant effect on the attractiveness ratings of female faces (p = .084), but it did benefit the perceived attractiveness of male faces which were initially rated lower (p = .16). Gender and age also played a significant role, as both male and female participants rated female stimuli higher than male stimuli (p < .001), and younger participants rated both genders as less attractive than older participants (p < .01). However, there was no significant influence of the mask's color on attractiveness. During the eye-tracking analysis, the periorbital region was of greater interest while masked, with the time to first fixation for the eyes being lower than the non-masked stimulus (p < .001) and showed a longer dwell time (p < .001). The lower face was shown less interest while masked as the time to first fixation was higher (p < .001) and the fixation count was less (p < .001). Mask color did not influence the scan path and there was no difference in revisits to the mask area between red or blue masks (p = .202), nor was there a difference in time to first fixation (p = .660).
CONCLUSIONS
The study findings indicate that there is an interplay between the gender and age of the participant and the facial stimuli. The color red did have an effect on the perception attractiveness, however not in female faces. The results suggest that masks, especially red ones, might be more beneficial for male faces, which were perceived as less attractive without a mask. However, wearing a mask did not significantly impact already attractive faces. The eye-tracking results revealed that the periorbital region attracted more attention and was fixated on more quickly while wearing a mask, indicating the importance of eyes in social interaction and aesthetic perception.
Topics: Humans; Male; Female; COVID-19; Judgment; Pandemics; Masks; Beauty
PubMed: 37541135
DOI: 10.1016/j.actpsy.2023.103994 -
Ophthalmic Plastic and Reconstructive...While sinusitis-related orbital cellulitis (SROC) and periorbital necrotizing fasciitis (PNF) share similar clinical presentations, they are managed differently, making...
PURPOSE
While sinusitis-related orbital cellulitis (SROC) and periorbital necrotizing fasciitis (PNF) share similar clinical presentations, they are managed differently, making rapid recognition of the appropriate clinical entity critical to optimal outcomes. This study was performed to assess whether serologic testing might help clinicians to distinguish between SROC and PNF.
METHODS
A retrospective review analysis was used to compare initial complete blood counts and comprehensive metabolic panels among adult patients with SROC and PNF. Statistical evaluations were used to determine the significance of differences between the groups.
RESULTS
Thirteen patients with PNF and 14 patients with SROC were identified. The 2 groups were similar in age, gender, and likelihood of immunosuppression ( p > 0.05 for each metric). Mean leukocyte counts were 18.52 (standard deviation = 7.02) and 10.31 (standard deviation = 5.77) for PNF and SROC, respectively ( p = 0.0057). White blood cell levels were above normal limits for 12 patients with PNF (92.3%) and 7 patients with SROC (50%) ( p = 0.017). No other laboratory test was significantly different between the 2 groups.
CONCLUSIONS
While the majority of serologic testing was quite similar in patients with either SROC or PNF, leukocyte levels may represent an important clue to distinguish between the two diseases. Clinical evaluation remains the gold standard to make the proper diagnosis, but markedly elevated white blood cell counts should prompt clinicians to at least consider a diagnosis of PNF.
Topics: Adult; Humans; Orbital Cellulitis; Fasciitis, Necrotizing; Sinusitis; Retrospective Studies; Anti-Bacterial Agents
PubMed: 37338341
DOI: 10.1097/IOP.0000000000002437 -
Cureus Jul 2023Mucormycosis is a fulminant angioinvasive fungal infection that occurs in an immunocompromised condition, most commonly in diabetic patients. Rhino-cerebral and...
Mucormycosis is a fulminant angioinvasive fungal infection that occurs in an immunocompromised condition, most commonly in diabetic patients. Rhino-cerebral and pulmonary infections are common but may also lead to disseminated disease associated with a high mortality rate (almost 100%). Here we report on an elderly diabetic lady presented with a headache and altered level of consciousness and peri-orbital swelling following coronavirus disease 2019 (COVID-19). Imaging studies revealed a single large space-occupying lesion in the frontal lobe extending to the left orbit and sinusitis. An excisional biopsy was taken from the middle meatus of the nasal cavity and histopathology findings were broad aseptate hyphae branching at the right angle which suggests mucormycosis. Liposomal amphotericin B was started but the patient developed acute kidney injury (AKI) and bi-cytopenia (thrombocytopenia and anemia) followed by sepsis resulting in death. Though this is a rapidly progressing disease with a high mortality rate, a strong level of suspicion and early diagnosis can save lives.
PubMed: 37644947
DOI: 10.7759/cureus.42652