RESUMO
ABSTRACT: Ligneous conjunctivitis is a rare cause of chronic conjunctivitis that may be triggered by ocular insults such as trauma or infections. We present an interesting case of ligneous conjunctivitis caused by a viral infection that responded well to conservative management. Topical cyclosporine and heparin are a good treatment regimen that caused resolution of lesions and prevented recurrences.
Assuntos
Conjuntivite Viral , Conjuntivite , Dermatopatias Genéticas , Humanos , Conjuntivite/diagnóstico , Conjuntivite/tratamento farmacológico , Conjuntivite/etiologia , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/tratamento farmacológico , OlhoRESUMO
Purpose: To evaluate and establishe the number of patients with ocular manifestations in the early phase of systemic COVID-19 infection.Methods: A cross-sectional study was performed in a COVID-19 referral center regarding ocular findings in patients with COVID-19 in the first few days of the disease. The patients were submitted to a clinical examination, an ophthalmic exam and a RT-PCR for SARS-COV-2.Results: Out of 1740 patients, we reported 108 patients with ocular manifestations. Forty-nine with markedly conjunctivitis had conjunctival swab positive for SARS-COV-2, four of them developed keratitis. There were mostly no evidence of retinopathy nor decrease in visual acuity. They had no marked clinical symptoms, which can contribute and demonstrate that the virus may cause ocular disease as an only finding or in the very early stage of the infection.Conclusion: Patients were in the first days of COVID-19 infection, presented ocular manifestations suggested to be related to the virus and need to be aware of the pathways of transmissions.
Assuntos
COVID-19/complicações , Túnica Conjuntiva/patologia , Conjuntivite Viral/diagnóstico , Infecções Oculares Virais/diagnóstico , RNA Viral/análise , SARS-CoV-2/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Túnica Conjuntiva/virologia , Conjuntivite Viral/etiologia , Conjuntivite Viral/virologia , Estudos Transversais , Infecções Oculares Virais/etiologia , Infecções Oculares Virais/virologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Tempo , Adulto JovemRESUMO
A captive loggerhead turtle (Caretta caretta) of unknown sex, 3 years of age, presented with bilateral mucoid secretions, severe chemosis, conjunctival hyperemia, and globe retraction. The animal was evaluated ophthalmologically and systemically, and hematological, microbiological, and conjunctival cytological and biopsy samples were collected for complementary diagnosis. The histopathological examination showed amphophilic intranuclear inclusions associated with severe inflammatory infiltrate. The diagnosis of Chelonid alphaherpesvirus 5 (ChAHV 5) was confirmed with end point PCR. Following systemic treatment with L-lysine, acyclovir and vitamin A, the ocular signs resolved. No amphophilic intranuclear inclusions were seen in a follow-up biopsy 5 months later, and there has been no recurrence of clinical ophthalmic signs during a 4-year follow-up. It is suggested that ChAHV 5 be considered as a differential diagnosis in captive marine turtles that present for conjunctival disease other than fibropapillomatosis.
Assuntos
Alphaherpesvirinae , Conjuntivite Viral/veterinária , Infecções por Herpesviridae/veterinária , Tartarugas , Animais , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/tratamento farmacológico , Conjuntivite Viral/patologia , Infecções por Herpesviridae/diagnóstico , Infecções por Herpesviridae/tratamento farmacológico , Infecções por Herpesviridae/virologia , Lisina/uso terapêutico , Reação em Cadeia da Polimerase/veterináriaRESUMO
La infección por molusco contagioso (MC) en adultos se asocia frecuentemente a transmisión sexual y/o inmunodepresión, por ejemplo, por VIH. En este grupo, la manifestación clínica suele ser atípica. A continuación, se presenta el caso de un paciente con diagnóstico de VIH, bajo recuento de CD4 y carga viral elevada que consulta por múltiples MC en genitales, tronco, cara y ojos además de conjuntivitis en ojo derecho. Se mantuvo terapia antirretroviral (TARV) y se indicó tratamiento para conjuntivitis. La infección por MC en pacientes con VIH se asocia a etapas SIDA con un aumento de los casos a menor recuento de linfocitos CD4, generalmente menor a 200 cel/mL. La pobre respuesta inmune celular de estos pacientes explica su comportamiento clínico atípico. Este grupo presenta una mayor mortalidad que el de pacientes seropositivos sin MC, lo que se explica por la mayor inmunosupresión asociada. El diagnóstico es clínico, aunque podría verse entorpecido cuando hay compromiso ocular por la presencia de lesiones atípicas que hacen necesario considerar diversos diagnósticos diferenciales. El tratamiento es controversial y tiende a existir una baja respuesta y recidiva frente a terapias convencionales en pacientes con VIH cuando la inmunosupresión es marcada por el recuento CD4 muy bajo. La TARV pareciera ser la mejor alternativa para su tratamiento, sin embargo, es importante considerar posibles complicaciones asociadas, como la instauración de síndrome de restauración inmunológica una vez iniciada. Esto podría traducirse en lesiones oculares graves cuando existe compromiso en este órgano
Molluscum contagiosum (MC) infection in adults is frequently associated with sexual transmission and / or immunosuppression, for example by HIV. In this group, the clinical manifestation is usually atypical. Herein we present the case of a patient with a diagnosis of HIV, a low CD4 count and a high viral load who consulted for multiple MC in the genitals, trunk, face and eyes, as well as conjunctivitis in the right eye. Antiretrovitral therapy (ART) was maintained and treatment for conjunctivitis was indicated. MC infection in HIV patients is associated with AIDS stages with an increase in cases with a lower CD4 lymphocyte count, generally less than 200 cells / mL. The poor cellular immune response of these patients explains their atypical clinical behavior. This group presents a higher mortality than that of seropositive patients without MC, which is explained by the greater associated immunosuppression. The diagnosis is clinical, although it could be hampered when there is ocular compromise due to the presence of atypical lesions that make it necessary to consider various differential diagnoses. Treatment is controversial and there tends to be a poor response and relapse to conventional therapies in patients with HIV when immunosuppression is marked by a very low CD4 count. ART seems to be the best alternative for its. However, it is important to consider possible associated complications such as the onset of immune restoration syndrome once it has been started. This could translate into serious eye injuries when this organ is compromised
Assuntos
Humanos , Masculino , Adulto , Infecções por HIV/complicações , Conjuntivite Viral/etiologia , Molusco Contagioso/etiologia , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/tratamento farmacológico , Molusco Contagioso/diagnóstico , Molusco Contagioso/tratamento farmacológicoRESUMO
PURPOSE: To evaluate the sequelae due to epidemic viral conjunctivitis (VC) for a possible association with inflammatory trachoma in schoolchildren. METHODS: A cross-sectional survey was performed of 2,093 schoolchildren in public schools in Sao Paulo State, Brazil. The exams were conducted according to the WHO definitions to detect trachoma. We evaluated the prevalence and the association between inflammatory trachoma and sequelae due to VC. RESULTS: The prevalence of inflammatory trachoma in schoolchildren in Botucatu City was 2.9% (CI: 1.2-17.3%). The prevalence of sequelae from VC was 0.007% (CI: 0 to 0.033%). Acute bacterial conjunctivitis was detected in 0.001%. There was no association between inflammatory trachoma and VC-related sequelae or acute bacterial conjunctivitis. CONCLUSION: An outbreak of epidemic VC can lead to definitive sequelae in the tarsal conjunctiva. The sequelae from VC were detected in 0.007% of the schoolchildren and were not associated with inflammatory trachoma.
Assuntos
Conjuntivite Viral/epidemiologia , Epidemias/estatística & dados numéricos , Infecções Oculares Virais/epidemiologia , Tracoma/epidemiologia , População Urbana , Brasil/epidemiologia , Criança , Conjuntivite Viral/diagnóstico , Estudos Transversais , Progressão da Doença , Infecções Oculares Virais/diagnóstico , Feminino , Humanos , Incidência , Masculino , Prevalência , Tracoma/diagnósticoRESUMO
Objectives: To perform molecular diagnosis of microbial agents (FHV-1, FCV, Mycoplasma felis, and Chlamydophila felis) in kittens with conjunctivitis and correlate the clinical signs with clinical severity. Material and Methods: A total of 108 conjunctival swab were collected from kittens without (G1; n = 40) and with (G2; n = 68) clinical signs of conjunctivitis. Animals from G2 group were scored from 1 (mild) to 4 (severe) according to the severity of conjunctivitis. All samples were submitted to PCR and RT-PCR. Results: FHV-1 was detected in 62/108 (57.4%) of samples, FCV in 40/108 (37.0%), M. felis in 11/108 (10.2%) and C. felis in 26/108 (24.1%). Mixed infections were detected in 39/108 (36.1%). In G1, 28/40 (70.0%) were positive for one or more agents, in G2, 58/68 (85.3%) were positive (P = 0.03). In 1, single infections by FHV-1were found in 21/40 (52.5%) samples, FCV in 2/40 (5.0%), C. felis in 1/40 (2.5%), and no pathogens were detected in 12/40 (30%) of samples, while mixed infections accounted for 29/40 (72.5%) of the cases. In G2, single FHV-1 infections were found in 31/68 (45.6%) samples, FCV in 10/68 (14.7 %), M. felis in 2/68 (3.0%) and C. felis also in 2/68 (3.0%), and no pathogens were detected in 10/68 (14.7%) samples, while mixed infections accounted for 36/68 (52.0%) of the cases. They were categorized as grade 1, 20/68 (29.4%), grade 2, 14/68 (20.6%), grade 3, 21/68 (30.9%) and grade 4, 13/68 (19.1%). The presence of FHV-1 and FCV is equally distributed among the four categories. More severe clinical signs, scores 3 and 4, are related to coinfections by C. felis and M. felis. Conclusions: FHV-1, FCV, C. felis and M. felis were identified in feline conjunctivitis. Co-infections are related to more severe cases of conjunctivitis.Molecular diagnosis is helpful to detect asymptomatic carriers and is a rapid and accurate method to determine the pathogen of feline conjunctivitis.(AU)
O objetivo deste estudo foi realizar diagnóstico molecular de agentes microbiológicos (FHV-1, FCV, Mycoplasma felis e Chlamydophila felis) em gatos filhotes e associar a presença dos patógenos à gravidade dos sinais clínicos de conjuntivite. Foram coletadas um total de 108 amostras de suabe conjuntival de filhotes felinos assintomáticos (G1; n = 40) e sintomáticos (G2; n = 68). Animais do G2 foram categorizados de 1 (leve) até 4 (grave), de acordo com o quadro clínico de conjuntivite. As 108 amostras foram submetidas à PCR e RT-PCR. O FHV-1 foi detectado em 57,4% das amostras, o FCV em 37%, o M. felis em 10,2% e o C. felis em 24,1%. Coinfecções, por sua vez, foram detectadas em 36,1%. No G1, 70% das amostras foram positivas para um ou mais patógenos. No G2, 85,3% apresentavam infecções (P = 0,03). No G1, monoinfecções por FHV-1 foram diagnosticadas em 52,5% das amostras, por FCV em 5%, por C. felis em 2,5%, e em 30% das amostras analisadas nenhum dos patógenos estudados foi encontrado. Coinfecções, por sua vez, estavam presentes em 72,5% das amostras. No G2, monoinfecções por FHV-1 foram encontradas em 45,6% das amostras, por FCV em 14,7 %, por M. felis em 3% e por C. felis também em 3%. Nenhum dos patógenos estudados foi encontrado em 14,7% das amostras analisadas. Coinfecções, responsáveis por 52% dos casos, foram categorizados como Grau 1 (29,4%), Grau 2 (20,6%), Grau 3 (30,9%) e Grau 4 (19,1%). A presença de FHV-1 e FCV está igualmente distribuída entre as quatro categorias. Os sinais clínicos mais graves (graus 3 e 4) estão relacionados a coinfecções por C. felis e M. felis. Os agentes microbiológicos FHV-1, FCV, C. felis e M. felis foram encontrados em animais com conjuntivite. Coinfecções estão relacionadas aos casos mais graves. Por fim, concluiu-se que o diagnóstico molecular, além de detectar portadores assintomáticos, é um método rápido e acurado para o diagnóstico do patógeno causador da conjuntivite felina.(AU)
Assuntos
Animais , Gatos , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/veterinária , Infecções Oculares Virais/veterinária , Calicivirus Felino , Chlamydophila , Coinfecção/veterinária , Herpesviridae , Técnicas de Diagnóstico Molecular/veterinária , Mycoplasma , Reação em Cadeia da Polimerase/veterináriaRESUMO
Objectives: To perform molecular diagnosis of microbial agents (FHV-1, FCV, Mycoplasma felis, and Chlamydophila felis) in kittens with conjunctivitis and correlate the clinical signs with clinical severity. Material and Methods: A total of 108 conjunctival swab were collected from kittens without (G1; n = 40) and with (G2; n = 68) clinical signs of conjunctivitis. Animals from G2 group were scored from 1 (mild) to 4 (severe) according to the severity of conjunctivitis. All samples were submitted to PCR and RT-PCR. Results: FHV-1 was detected in 62/108 (57.4%) of samples, FCV in 40/108 (37.0%), M. felis in 11/108 (10.2%) and C. felis in 26/108 (24.1%). Mixed infections were detected in 39/108 (36.1%). In G1, 28/40 (70.0%) were positive for one or more agents, in G2, 58/68 (85.3%) were positive (P = 0.03). In 1, single infections by FHV-1were found in 21/40 (52.5%) samples, FCV in 2/40 (5.0%), C. felis in 1/40 (2.5%), and no pathogens were detected in 12/40 (30%) of samples, while mixed infections accounted for 29/40 (72.5%) of the cases. In G2, single FHV-1 infections were found in 31/68 (45.6%) samples, FCV in 10/68 (14.7 %), M. felis in 2/68 (3.0%) and C. felis also in 2/68 (3.0%), and no pathogens were detected in 10/68 (14.7%) samples, while mixed infections accounted for 36/68 (52.0%) of the cases. They were categorized as grade 1, 20/68 (29.4%), grade 2, 14/68 (20.6%), grade 3, 21/68 (30.9%) and grade 4, 13/68 (19.1%). The presence of FHV-1 and FCV is equally distributed among the four categories. More severe clinical signs, scores 3 and 4, are related to coinfections by C. felis and M. felis. Conclusions: FHV-1, FCV, C. felis and M. felis were identified in feline conjunctivitis. Co-infections are related to more severe cases of conjunctivitis.Molecular diagnosis is helpful to detect asymptomatic carriers and is a rapid and accurate method to determine the pathogen of feline conjunctivitis.(AU)
O objetivo deste estudo foi realizar diagnóstico molecular de agentes microbiológicos (FHV-1, FCV, Mycoplasma felis e Chlamydophila felis) em gatos filhotes e associar a presença dos patógenos à gravidade dos sinais clínicos de conjuntivite. Foram coletadas um total de 108 amostras de suabe conjuntival de filhotes felinos assintomáticos (G1; n = 40) e sintomáticos (G2; n = 68). Animais do G2 foram categorizados de 1 (leve) até 4 (grave), de acordo com o quadro clínico de conjuntivite. As 108 amostras foram submetidas à PCR e RT-PCR. O FHV-1 foi detectado em 57,4% das amostras, o FCV em 37%, o M. felis em 10,2% e o C. felis em 24,1%. Coinfecções, por sua vez, foram detectadas em 36,1%. No G1, 70% das amostras foram positivas para um ou mais patógenos. No G2, 85,3% apresentavam infecções (P = 0,03). No G1, monoinfecções por FHV-1 foram diagnosticadas em 52,5% das amostras, por FCV em 5%, por C. felis em 2,5%, e em 30% das amostras analisadas nenhum dos patógenos estudados foi encontrado. Coinfecções, por sua vez, estavam presentes em 72,5% das amostras. No G2, monoinfecções por FHV-1 foram encontradas em 45,6% das amostras, por FCV em 14,7 %, por M. felis em 3% e por C. felis também em 3%. Nenhum dos patógenos estudados foi encontrado em 14,7% das amostras analisadas. Coinfecções, responsáveis por 52% dos casos, foram categorizados como Grau 1 (29,4%), Grau 2 (20,6%), Grau 3 (30,9%) e Grau 4 (19,1%). A presença de FHV-1 e FCV está igualmente distribuída entre as quatro categorias. Os sinais clínicos mais graves (graus 3 e 4) estão relacionados a coinfecções por C. felis e M. felis. Os agentes microbiológicos FHV-1, FCV, C. felis e M. felis foram encontrados em animais com conjuntivite. Coinfecções estão relacionadas aos casos mais graves. Por fim, concluiu-se que o diagnóstico molecular, além de detectar portadores assintomáticos, é um método rápido e acurado para o diagnóstico do patógeno causador da conjuntivite felina.(AU)
Assuntos
Animais , Gatos , Infecções Oculares Virais/veterinária , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/veterinária , Técnicas de Diagnóstico Molecular/veterinária , Reação em Cadeia da Polimerase/veterinária , Coinfecção/veterinária , Chlamydophila , Calicivirus Felino , Herpesviridae , MycoplasmaRESUMO
Objetivo: Avaliar a prevalência de Adenovírus como agente etiológico da conjuntivite, em clínica médica oftalmológica especializada, em Viçosa, Minas Gerais, Brasil. Métodos: Amostras da secreção conjuntival de 91 pacientes clinicamente diagnosticados com conjuntivite foram submetidos à reação em cadeia da polimerase (PCR), utilizando primers degenerados para a região codificadora do gene da proteína estrutural II. Posteriormente as amostras positivas foram submetidas a sequenciamento e genotipagem. Resultados: A análise dos resultados de PCR revelou prevalência de 36,3% de Adenovírus. Não havendo distinção entre os sexos e com maior prevalência na faixa etária de 26 a 65 anos com 60,60% dos casos positivos. O sequenciamento dos casos positivos por Adenovírus revelaram a presença dos sorotipos 3, 4, 7, 8 e 34 circulante na região. Conclusão: No município de Viçosa, dois em cada cinco casos de conjuntivite são de etiologia adenoviral.
Objective: The aim of this study was to evaluate the prevalence of Adenovirus as a etiologic agent of conjunctivitis on a ophthalmic clinic in Viçosa, Minas Gerais, Brazil. Methods: Samples of conjunctival secretion from 91 patients clinically diagnosed with conjunctivitis were subjected to polymerase chain reaction (PCR) using degenerate primers targeted to the gene encoding the structural protein II. Positive samples were subsequently subjected to sequencing and genotyping. Results: PCR results showed 36.3% prevalence of Adenovirus. No differences between the sexes and was found to be higher in the age group 26-65 years with 60.60% of the positive cases. Sequencing of positive cases showed the presence of Adenovirus serotypes 3, 4, 7, 8, and 34 circulating in the region. Conclusion: In Viçosa two in five cases of conjunctivitis has Adenovirus as etiologic agent.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/etiologia , Serviços de Saúde Ocular , Infecções por Adenoviridae/epidemiologia , Reação em Cadeia da Polimerase , Brasil , Estudos TransversaisRESUMO
The adenoviral conjunctivitis is one of the biggest causes of conjunctival infection in the world. Conjunctivitis causes relatively nonspecific symptoms, as hyperaemia and chemosis. Even after biomicroscopy, complex laboratory tests, such as viral culture, are necessary to identify the pathogen or its etiology. To contribute to the better understanding of the pathobiology of the adenoviral conjunctivitis, the tear fluids of patients with unilateral acute adenovirus conjunctivitis (UAAC), normal donors (control) and patients with allergic conjunctivitis were analyzed. Tear samples were collected with Schirmer strips from control, allergic conjunctivitis and UAAC patients, diagnosed by clinical signs. UAAC tears were tested positive in viral cultures. After the elution, HA was quantified using an ELISA-like fluorometric assay and the protein profile was determined by SDS-PAGE. A profound increase in the HA tear content in UAAC patients was found when compared to control and ALC. This HA increase in UAAC tears remarkably was not observed in tears from contralateral eyes without clinical signs, nor in allergic conjunctivitis. In addition a distinct profile of UAAC tear proteins was observed in patients with UAAC. The quantification of HA in the tear fluid is a rapid, sensitive and specific test. This molecule might be a biomarker candidate for acute conjunctivitis.
Assuntos
Infecções por Adenovirus Humanos/diagnóstico , Conjuntivite Viral/diagnóstico , Proteínas do Olho/análise , Ácido Hialurônico/análise , Lágrimas/química , Doença Aguda , Infecções por Adenovirus Humanos/fisiopatologia , Adulto , Biomarcadores/análise , Estudos de Casos e Controles , Criança , Conjuntivite Viral/fisiopatologia , Conjuntivite Viral/virologia , Eletroforese em Gel de Poliacrilamida , Feminino , Humanos , Masculino , Sensibilidade e EspecificidadeRESUMO
During June-August 2012, Mexico's National Service for Health, Safety, and Food Quality reported outbreaks of highly pathogenic avian influenza (HPAI) A (H7N3) virus in poultry on farms throughout the state of Jalisco. This report describes two cases of conjunctivitis without fever or respiratory symptoms caused by HPAI A (H7N3) virus infection in humans associated with exposure to infected poultry.