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Pulmonary Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Charles S. Dela Cruz, Barbara Seaworth, Graham Bothamley
The salient features of progressive primary TB were defined by studies of TB in children at the beginning of the last century.15 Most patients with TB infection do not notice any symptoms.16 The earliest stages include fever and, rarely, there may be erythema nodosum (Figure 13.2) and phlyctenular keratoconjunctivitis (Figure 13.3). Then follows mediastinal lymph node TB as noted earlier. Endoscopic biopsy under ultrasound can make the diagnosis using both mycobacterial culture and histology.17 Large mediastinal lymph nodes can compress an airway (see Complications section); this is an indication for steroids in addition to standard TB treatment. Rarely, these lymph nodes may contain caseating granulomas, which may then erode into a bronchus and cause tuberculous pneumonia; the sputum smear is positive and the prognosis is poor.
Hymenolepis
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
People with light H. nana and H. diminuta infection (hymenolepiasis) are usually asymptomatic, although those with more than 2,000 worms or children with more than 15,000 eggs per gram of stool (as often happens with autoinfection, which results in massive numbers of worms) may display a wide range of gastrointestinal symptoms and allergic responses, including vomiting, anorexia, abdominal pain/cramps, bloody diarrhea/enteritis, hives, loss of appetite, headache, irritability/nervousness/restlessness, sleeplessness, dizziness, chronic urticaria, skin eruption, phlyctenular keratoconjunctivitis, weight loss, generalized weakness, stunted growth (underweight), and even life-threatening conditions in immunosuppressed, HIV-infected individuals. In particular, persistent antigenic stimulation due to an autoinfection cycle of H. nana may induce papular eruption. A common laboratory finding is increased eosinophil counts (eosinophilia).
Bilateral Phlyctenular Keratoconjunctivitis in the Context of Hidradenitis Suppurativa: A Case Report and Literature Review
Published in Ocular Immunology and Inflammation, 2022
Amparo Gargallo- Benedicto, Rodrigo Clemente-Tomás, María Pastor-Espuig, Adrian Ballano-Ruiz, Ana Garzarán -Teijeiro, Eva Alias-Alegre, María Nieves Navarro-Casado
Phlyctenular keratoconjunctivitis (PKC) is a delayed hypersensitivity reaction mainly caused by Staphylococcus aureus in our setting. Mycobacterium tuberculosis, other bacteria, herpes, or intestinal parasites are other possible causal antigens. This condition is one of several ocular disorders that arise as an expression of altered immune mechanisms. Phlyctenular keratoconjunctivitis recurrence may be triggered by antigen presentation to the sensitized ocular tissue, or through the bloodstream from a site of infection elsewhere.
Pediatric Ocular Acne Rosacea: Clinical Features and Long Term Follow-Up of Sixteen Cases
Published in Ocular Immunology and Inflammation, 2021
We retrospectively reviewed the medical records of 16 consecutive patients with ocular acne rosacea younger than 16 years of age at the time of the diagnosis at Bayindir Hospital between March 2012 and January 2019. The study was approved by the institutional review board (BTEDK-03/19) and conducted in adherence to the tenets of the Declaration of Helsinki. Informed consent was obtained from all the subjects after explanation of the nature and possible consequences of the study. Ocular findings including lid telangiectasia, blepharitis, meibomian gland disease, recurrent chalazia, conjunctival hyperemia, phlyctenular keratoconjunctivitis, limbal vascularisation, corneal scarring and vascularisation, punctate keratopathy, peripheral corneal infiltrates and sterile corneal ulcers were noted. All patients had lid telangiectasia, posterior blepharitis, and meibomian gland disease. The skin involvement was diagnosed during the ophthalmological examination and all patients were consulted to dermatologists to confirm the diagnosis of cutaneous involvement. The demographic features of patients, mean delay for diagnosis, disease history, presence of cutaneous involvement, laterality, slit lamp findings at each visit were recorded from medical charts. If the ocular acne rosacea was not diagnosed in their first presentation to ophthalmologists, the cases described as patients with delayed diagnosis; calculated from the appearance of the symtomps until the definitive diagnosis. The patients underwent a detailed ophthalmological examination in each visit. Meibography (Sirius, CSO, Italy), anterior segment photography, ocular surface staining with flourescein and lissamine green, and tear osmolarity measurement (TearLab Corporation, CA, USA) were performed for the diagnosis and follow-up when appropriate. Meibography results were scaled according to software analysis in Scheimpflug camera.
Keratoconjunctivitis as a Single Entity in X-linked Agammaglobulinemia?
Published in Ocular Immunology and Inflammation, 2023
Stefan Mielke, Bastian Grundel, Sebastian M. Schmidt, Frank Tost
The critical question was whether the inflammation process was supported by the internally known immunological defect or an external reason. No suspicious specimens could be found, such as Staphylococcus aureus, Haemophilus influenzae, Chlamydia trachomatis or Mycobacterium tuberculosis, especially not in repeated conjunctival swabs. Nevertheless, the symptoms and corneal scars showed the same characteristics as phlyctenular keratoconjunctivitis.