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Prilozi 2012Fungi are a major part of the ecosystem. In fact, over 250 fungal species have been reported to produce human infections. More than ever, fungal diseases have emerged as...
Fungi are a major part of the ecosystem. In fact, over 250 fungal species have been reported to produce human infections. More than ever, fungal diseases have emerged as major challenges for physicians and clinical microbiologists. The aim of this study was to summarize the diagnostic procedures and endoscopic surgical treatment of patients with fungal rhinosinusitis. Eleven patients, i.e. 10% of all cases with chronic inflammation of paranasal sinuses, were diagnosed with fungal rhinosinusitis. Ten of them were patients with a noninvasive form, fungus ball, while only one patient was classified in the group of chronic invasive fungal rhinosinusitis which was accompanied with diabetes mellitus. All patients underwent nasal endoscopic examination, skin allergy test and had preoperative computed tomography (CT) scans of the sinuses in axial and coronal plane. Functional endoscopic sinus surgery was performed in 10 patients with fungus ball, while a combined approach, endoscopic and external, was done in the immunocompromised patient with the chronic invasive form of fungal rhinosinusitis. Most cases (9/11) had unilateral infection. In 9 cases infection was restricted to a single sinus, and here the maxillary sinus was most commonly affected (8/9) with infections in other patients being restricted to the sphenoid sinus (1/9). Two patients had infections affecting two or more sinuses. In patients with an invasive form of the fungal disease there was involvement of the periorbital and orbital tissues. In patients with fungus ball the mycelia masses were completely removed from the sinus cavities. Long-term outcome was positive in all the operated patients and no recurrence was detected. The most frequent fungal agent that caused rhinosinusitis was Aspergillus. Mucor was identified in the patient with the invasive form. Endoscopic examination of the nasal cavity and CT scanning of paranasal sinuses followed by endoscopic sinus surgery were represented as valuable diagnostic and therapeutic procedures for fungal rhinosinusitis.
Topics: Adult; Aged; Endoscopy; Female; Humans; Male; Middle Aged; Mycoses; Rhinitis; Sinusitis; Skin Tests; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 22952104
DOI: No ID Found -
Infectious Disease Clinics of North... Jun 2007Practitioners frequently have the opportunity to manage the child for whom the chief complaint is a swollen eye. Some children have trivial or self-limited disorders,... (Review)
Review
Practitioners frequently have the opportunity to manage the child for whom the chief complaint is a swollen eye. Some children have trivial or self-limited disorders, but others can have sight- or life-threatening problems. Noninfectious causes of the swollen eye include blunt trauma, tumor, local edema, and allergy. Infectious causes can be preseptal or orbital in origin. The differential diagnosis and management of these conditions are considered in this article.
Topics: Eye Infections, Bacterial; Humans; Orbit
PubMed: 17561075
DOI: 10.1016/j.idc.2007.03.008 -
Pediatrics in Review Sep 2004
Review
Topics: Abscess; Cellulitis; Child; Conjunctivitis; Diagnosis, Differential; Eye Infections; Hordeolum; Humans; Lacrimal Apparatus Diseases; Lymphadenitis; Orbit; Orbital Diseases; Respiratory Tract Infections
PubMed: 15342822
DOI: 10.1542/pir.25-9-312 -
The Pediatric Infectious Disease Journal Dec 2002
Comparative Study Review
Topics: Anti-Bacterial Agents; Cellulitis; Child; Child, Preschool; Diagnosis, Differential; Ethmoid Sinusitis; Female; Humans; Infant; Male; Orbital Diseases; Prognosis; Risk Assessment; Severity of Illness Index; Treatment Outcome
PubMed: 12488668
DOI: 10.1097/00006454-200212000-00014 -
Pediatrics Apr 2010Computed tomography (CT) is used often in the evaluation of orbital infections to identify children who are most likely to benefit from surgical intervention. Our... (Comparative Study)
Comparative Study
OBJECTIVES
Computed tomography (CT) is used often in the evaluation of orbital infections to identify children who are most likely to benefit from surgical intervention. Our objective was to identify predictors for intraorbital or intracranial abscess among children who present with signs or symptoms of periorbital infection. These predictors could be used to better target patients for emergent CT.
METHODS
This was a retrospective cohort study of all patients admitted to an urban pediatric tertiary care emergency department between 1995 and 2008. We included otherwise healthy patients with suspected acute clinical periorbital or orbital cellulitis without a history of craniofacial surgery, trauma, or external source of infection. Immunocompromised patients and patients with noninfectious causes of periorbital swelling were excluded. Variables analyzed included age, duration of symptoms, highest recorded temperature, previous antibiotic therapy, physical examination findings, laboratory results, and interpretation of imaging. CT scans of the orbit were reread by a neuroradiologist.
RESULTS
Nine hundred eighteen patients were included; 298 underwent a CT scan, and of those, 111 were shown to have an abscess. Although proptosis, pain with external ocular movement, and ophthalmoplegia were associated with presence of an abscess, 56 (50.5%) patients with abscess did not experience these symptoms. Other variables associated with the presence of an abscess in multivariate analysis were a peripheral blood neutrophil count greater than 10,000/microL, absence of infectious conjunctivitis, periorbital edema, age greater than 3 years, and previous antibiotic therapy (P < .05 for all). Our recursive partitioning model identified all high-risk (44%) patients as well as a low-risk (0.4%-2%) group (Rsq = 0.27).
CONCLUSIONS
We confirmed that patients with proptosis and/or pain or limitation of extraocular movements are at high risk for intraorbital abscess, yet many do not have these predictors. Other features can identify patients who do not have such obvious predictors but do have significant risk of disease. A recursive partitioning model is presented.
Topics: Child; Child, Preschool; Eye Diseases; Eye Infections, Bacterial; Female; Humans; Infant; Male; Orbital Cellulitis; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 20194288
DOI: 10.1542/peds.2009-1709 -
Il Giornale Di Chirurgia 2020A 45-year old male patient, with a past history of illicit drug abuse and hepatitis C, presented with a 2 day history of worsening eyelid edema. Examination of the globe...
A 45-year old male patient, with a past history of illicit drug abuse and hepatitis C, presented with a 2 day history of worsening eyelid edema. Examination of the globe was impossible due to eyelid fusion caused by extensive soft tissue damage. Based on the examination, a diagnosis of necrotic fasciitis secondary to VZV infection was Romamade. The patient received empirical treatment with intravenous acyclovir, meropenem and vancomycin. CT imaging demonstrated no ocular involvement. Lesions were cultivated, revealing presence of Streptococcus pyogenes. Intravenous clindamycin was added to his course. Improvement was gradually observed. The patient received treatment for a total of 21 days, resulting in excellent final outcome. His final visual acuity was 0.9 on a Snellen chart, without signs of ocular inflammation. No surgical intervention was required and lesions fully healed with conservative management. Clinical outcomes depend on prompt treatment initiation, whilst delay in the diagnosis can prove fatal.
Topics: Anti-Bacterial Agents; Antiviral Agents; Conservative Treatment; Drug Therapy, Combination; Eyelid Diseases; Fasciitis, Necrotizing; Humans; Male; Middle Aged; Streptococcal Infections; Streptococcus pyogenes; Varicella Zoster Virus Infection
PubMed: 32038022
DOI: No ID Found -
Journal of Medical Virology Dec 2020Epstein-Barr virus (EBV) infection occurs commonly in children and presents as a primary or reactivated infection, which are difficult for clinicians to distinguish....
Epstein-Barr virus (EBV) infection occurs commonly in children and presents as a primary or reactivated infection, which are difficult for clinicians to distinguish. This study investigated the clinical characteristics of the two types of infections. Children with detectable plasma EBV-DNA were retrospectively enrolled and divided into primary and reactivated infection group by EBV-specific antibody. We analyzed the patients' characteristics, clinical manifestations, complications, inflammatory biomarkers, and viral load. A total of 9.3% of children with reactivation were immunocompromised over the long-term. The primary infection mostly appeared as infectious mononucleosis (99.8%), while reactivation occurred as an infectious mononucleosis-like disease (65.0%), hemophagocytic syndrome (22.6%), chronic active EBV infection (5.3%) and lymphoma (3.5%). The incidence of fevers, cervical lymphoditis, periorbital edema, pharyngotonsillitis, hepatomegaly and splenomegaly in primary infection were 93.3%, 93.0%, 51.5%, 66.0%, 76.2% and 63.9%, respectively; the incidence of those symptoms in reactivation was 84.0%, 46.9%, 15.4%, 18.5%, 18.5%, and 43.3%, respectively. The incidence of digestive, respiratory, cardiovascular, neurological, hematological, genitourinary complications and multiple serous effusion in primary infection was 68.8%, 18.1%, 8.0%, 0.8%, 2.9%, 0.0% and 2.3%; whereas the incidence of these complications in reactivation was 56.2%, 22.5%, 14.1%, 8.0%, 38.9%, 0.3% and 19.0%. Patients with reactivation were more prone to multi-systemic damage. B-cells were lower, and CD8+ T-cells were higher in primary infection. Viral load was correlated with the level of different cytokines in primary and reactivated infection. EBV primary infection often presents as infectious mononucleosis. The reactivated infection affects more immunocompromised subjects with diverse and complex manifestations. Various complications are more commonly associated with reactivation as a result of different inflammatory responses to different types of infection.
Topics: Humans; Child; Female; Male; Epstein-Barr Virus Infections; Retrospective Studies; Child, Preschool; Herpesvirus 4, Human; Viral Load; Virus Activation; Adolescent; Antibodies, Viral; DNA, Viral; Infant; Latent Infection; Infectious Mononucleosis; Immunocompromised Host; Incidence; Lymphoma
PubMed: 32558948
DOI: 10.1002/jmv.26202 -
Pediatrics in Review May 1995
Review
Topics: Bacterial Infections; Cellulitis; Child; Eyelid Diseases; Humans; Orbital Diseases
PubMed: 7753730
DOI: 10.1542/pir.16-5-163 -
Journal Francais D'ophtalmologie Nov 2022
Topics: Humans; Fasciitis, Necrotizing; Orbital Diseases; Streptococcal Infections; Face
PubMed: 35489987
DOI: 10.1016/j.jfo.2021.11.013 -
BMC Infectious Diseases Aug 2018Colonisation with Panton-Valentine Leukocidin expressing strains of Staphylococcus aureus (PVL + SA) is characterised by recurrent skin and soft tissue infections....
BACKGROUND
Colonisation with Panton-Valentine Leukocidin expressing strains of Staphylococcus aureus (PVL + SA) is characterised by recurrent skin and soft tissue infections. While periorbital and orbital infections are common in children and frequently caused by S. aureus the role of PVL + SA in recurrent eye infections has not been studied. This study aimed to detect and report frequency and recurrence of periorbital or orbital infections as additional symptoms of PVL + SA colonisation in children.
METHODS
We conducted a retrospective cohort study of pediatric patients who were treated for PVL + SA skin and soft tissue infection in our in- and outpatient clinics in Berlin, Germany from January 2012 to January 2017. We identified cases with periorbital or orbital infections in the year prior to the first PVL + SA evidence. In these cases, we conducted follow-up interviews by phone to determine recurrence of symptoms after the completion of decolonisation procedures.
RESULTS
Fifty pediatric patients (age range: one week to 17 years) were evaluated and treated for PVL + SA infections in the reported time period. 19 patients (38%) reported periorbital infection or conjunctivitis, with recurrent hordeola as the most frequent finding (n = 9; 18%). Reappearance of hordeola (n = 5) was associated with recurrence of skin and soft tissue infections and/or de novo detection of PVL + SA. No further hordeola or other eye infections occurred after successful decolonisation.
CONCLUSION
Our findings suggest a frequent involvement of periorbital skin in children with PVL + SA infections. Pediatric patients with recurrent periorbital infections might benefit from PVL + SA screening and consecutive decolonisation procedures.
Topics: Adolescent; Bacterial Toxins; Berlin; Child; Child, Preschool; Conjunctivitis, Bacterial; Exotoxins; Female; Humans; Infant; Infant, Newborn; Leukocidins; Male; Retrospective Studies; Soft Tissue Infections; Staphylococcal Infections; Staphylococcus aureus
PubMed: 30081842
DOI: 10.1186/s12879-018-3281-8