Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

A new record of Scedosporium dehoogii isolated from paddy field soil in Iran: Phylogeny and antifungal susceptibility profiles

Background and Purpose

Scedosporium species are ubiquitous environmental fungi, which are considered emerging agents that trigger disease in humans and animals. The present study aimed to determine Scedosporium dehoogii strain isolated from paddy field soil samples using semi-selective media and evaluate its antifungal susceptibility profile.

Materials and Methods

Three paddy field soil samples were collected during an investigation for the isolation of Scedosporium species in Mazandaran province, Iran. Morphological and molecular analyses based on ITS-rDNA sequencing were performed. Furthermore, in vitro antifungal susceptibility testing for conventional drugs and novel imidazole (luliconazole) was performed based on Clinical and Laboratory Standards Institute M38-A3 guidelines.

Results

In this study, S. dehoogii was isolated from the soil in paddy fields. Based on the results, itraconazole and luliconazole showed the least and most antifungal activity against this isolate, respectively.

Conclusion

Based on the findings, molecular identification was essential for distinguishing the species of S. dehoogii. Remarkably, luliconazole showed potent activity against this strain.

Ocular Syphilis as a Cause of Chronic Postoperative Uveitis Followed by a Localized Ocular Jarisch-Herxheimer-like Reaction

OBJECTIVE

The case draws attention to syphilis as a cause of chronic postoperative uveitis following cataract surgery and is the first to document transient worsening of ocular inflammation without systemic symptoms after initiation of treatment, suggesting a localized Jarisch-Herxheimer-like reaction.

DESIGN

Case report.

RESULTS

The average thickness of the retinal nerve fiber layer was used as an objective measure of intraocular inflammation. The patient's nerve edema worsened during a standard neurosyphilis treatment course and returned to normal several weeks after completion of therapy.

CONCLUSION

Syphilis serologic testing should be strongly considered in the work-up for chronic postoperative uveitis. A localized ocular Jarisch-Herxheimer-like reaction may occur and should not detract from completion of neurosyphilis treatment.

Posterior segment manifestations and imaging features post-COVID-19

Background

To report the posterior segment (uvea and retinal) manifestations and imaging characteristics of eyes of patients with and after coronavirus disease 2019 (COVID-19).

Methods

We searched the PubMed/MEDLINE database to identify relevant articles using the following search terms: COVID-19, SARS-CoV-2, retina, uvea, optic nerve, retinal findings, posterior segment manifestations, and endophthalmitis. Articles published from December 1, 2019, to May 30, 2021, and indexed in PubMed/ MEDLINE were screened.

Results

For the purpose of this review, we included clinical features of 26 case reports and 8 case series. The posterior segment manifestations reported included cotton wool spots, retinal hemorrhages, central serous retinopathy, papillophlebitis, optic neuritis, panuveitis, multifocal retinitis, necrotizing retinitis, central retinal artery/vein occlusion, and Purtschner like retinopathy. In this review, we have also included optical coherence tomography angiography (OCTA) features that have been described in COVID-19 patients with pneumonia.

Conclusions

COVID-19 patients can experience uveo-retinal manifestations even after recovery. These patients, even if asymptomatic for eye symptoms, should undergo an eye evaluation to rule out posterior segment involvement. OCTA performed in these patients revealed microvascular changes in the superficial and deep retinal plexuses. Some of these patients may require anticoagulant or antiplatelet therapy.