case report n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Case report PowerPoint Presentation
Download Presentation
Case report

Loading in 2 Seconds...

play fullscreen
1 / 19

Case report - PowerPoint PPT Presentation


  • 206 Views
  • Uploaded on

Case report . Reporter:I2 吳孟峰 Date:94.12.26. History. A 29-year-old women :severe eye pain and a recent loss of vision in her right eye over the past few weeks Hx of contact lenses since the age of 20 She clean her lenses with tap water or normal saline no previous eye problems

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Case report' - glen


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
case report

Case report

Reporter:I2吳孟峰

Date:94.12.26

history
History
  • A 29-year-old women :severe eye pain and a recent loss of vision in her right eye over the past few weeks
  • Hx of contact lenses since the age of 20
  • She clean her lenses with tap water or normal saline
  • no previous eye problems
  • Physical examination:cornealulcer
thinking process
Thinking process
  • severe eye pain
  • trauma,chemical substence,foreign body,contact lenceconeral ulcer or abrasion,
  • Subconjunctival hemorrhage
  • Allergic conjunctivitis
  • Keratitis
  • Endophthalmitis
  • Meibomianitis
  • Herpes simplex virus
thinking process1
Thinking process
  • loss of vision
  • Cataract
  • Glaucoma
  • Macular Degeneration
  • Central serous chorioretinopathy
  • Diabetic retinopathy
  • Melanoma and other tumor
thinking process2
Thinking process
  • Corneal ulcer:

wear contact lense too long,or over night

Chemical burns

Tiny tears

foreign body,

infections (bacteria,virus,parasites),

Scratches with dirty hands or unclean contact lense

slide6
infection was suspectedDue to severe eye paincorneal biopsyamebic trophozoites
  • Histological preparations neutrophils and monocytes
  • Cultures negative of bacteria and viruses
  • amebic parasite was found
amebic infected to persons
Amebic infected to persons
  • Entamoeba:

Entamoeba histolytica,

Entamoeba hartmanni,

Entamoeba coli,

Entamoeba gingivalis

Entamoeba polecki

amebic infected to persons1
Amebic infected to persons

Other intestinal amebae

Iodamoeba butschlii

Endolimax nana

The opportunistic amebae

Naegleria fowleri

Acanthamoeba spp.

amebic infected to persons2
Amebic infected to persons

Acanthamoeba spp.

  • A.astronyxis:CNS infection
  • A.castellanii:eye and CNS
  • A.culbertsoni:eye and CNS
  • A.hatchetti:eye infected only
  • A.palestinensis:CNS infection
  • A.polyphaga:eye infected only
  • A.rhysodes:eye and CNS
why difficult to diagnose microscopically
Why difficult to diagnose microscopically?
  • Opportunistic amebae:

Naegleria fowleritrophozoites

Acanthamoeba spp. trophozoites or cyst

how does the laboratory culture this parasite
How does the laboratory culture this parasite?
  • Naegleria fowleriaspiration of
  • CSF37℃,4-5hrs
  • Acanthamoeba spp.CSF or brain tissue
  • corneal biopsy
which cytological techniques for the diagnosis of this infection
Which cytological techniques for the diagnosis of this infection?
  • Naegleria fowleri37℃,4-5hrsFlagellate
  • Acanthamoeba spp.trophozoites or cyst
risk factor
risk factor
  • Swimming
  • Immunocompromise(ex:AIDS)
  • weakness
  • clean lense without sterilizing
diagnosis
Diagnosis
  • Acanthamoeba spp. Infected corneal ulcer was highly suspected
complication
Complication
  • Granulomatous amebic encephalitis(GAE)
  • Mental state change,
  • headache
  • seizure
  • neck stiff
  • Nausea and vomiting
  • Loss of vision
treatment
Treatment
  • Granulomatous amebic encephalitis(GAE):operation(excision)
  • Amebic related corneal ulcer:dibromopropamide oint or propamide isethionate eyedrops with neomycin eyedrops or itraconazole
  • Antibiotics:ketoconazole,penicillin or chloramphenicol or sulfamethazine
prevention
Prevention
  • 少戴隱形眼鏡
  • 清潔消毒眼鏡要落實
  • 不戴隱形眼鏡去游泳
  • 按時遵循指示配戴及清潔消毒鏡片