Dataset Information

Tsukamurella pulmonis conjunctivitis in patients with an underlying nasolacrimal duct obstruction - report of two cases.

ABSTRACT: Tsukamurella pulmonis ( Actinobacteria ), a Gram-positive, obligate aerobic and weakly or variably acid-fast bacterium, is an opportunistic pathogen. Here we report two cases of conjunctivitis caused by T. pulmonis . Both patients had a previous history of nasolacrimal duct obstruction (NLDO). Isolation of T. pulmonis was performed on chocolate, tryptic soy blood and Columbia nalidixic agars. After 24 h of incubation, odourless, white-greyish, membrane-like colonies were observed. The VITEK-2 bacterial identifier system failed to identify the species, while Vitek-MS matrix-assisted laser desorption ionization time-of-flight technology, successfully identified the isolate from case 2 but not from case 1. Final identification was verified using 16S rRNA gene sequencing. An antibiogram was performed and according to the results cefazoline in addition to vancomycin eye drops for 5 days, were suggested as a treatment in case 1. In case 2 the infection was ended without treatment. This is the first report of Tsukamurella as a pathogen that causes conjunctivitis in patients with NLDO.

SUBMITTER: Kechker P

PROVIDER: S-EPMC8209640 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Tsukamurella pulmonis conjunctivitis in patients with an underlying nasolacrimal duct obstruction - report of two cases.

Kechker Peter P Senderovich Yigal Y Ken-Dror Shifra S Laviad-Shitrit Sivan S Halpern Malka M

Access microbiology 20201209 2

Tsukamurella pulmonis ( Actinobacteria ), a Gram-positive, obligate aerobic and weakly or variably acid-fast bacterium, is an opportunistic pathogen. Here we report two cases of conjunctivitis caused by T. pulmonis . Both patients had a previous history of nasolacrimal duct obstruction (NLDO). Isolation of T. pulmonis was performed on chocolate, tryptic soy blood and Columbia nalidixic agars. After 24 h of incubation, odourless, white-greyish, membrane-like colonies w ...[more]

PMID: 34151142

Similar Datasets

Project description:ImportanceAlthough the overall rate of spontaneous resolution in congenital nasolacrimal duct obstruction (CNLDO) and efficacy of probing have been documented in the literature, the optimal timing of intervention has not been established.ObjectiveTo report new findings regarding spontaneous resolution in a large cohort of children with CNLDO.Design, setting, and participantsThe medical records of 1998 consecutive infants diagnosed with CNLDO from January 1, 1995, through December 31, 2004, while residing in Olmsted County, Minnesota, were retrospectively reviewed. Data were analyzed between January 1, 2015, and January 2017.Main outcomes and measuresRate of spontaneous resolution over time and by sex.ResultsThe cohort, diagnosed at a median age of 1.2 months (interquartile range, 0.4-3.6), was 48% girls (n = 959) and 89% white (n = 1626; 173 were unreported). Among the 1998 cases, 1669 (83.5%) spontaneously resolved, 289 (14.5%) underwent treatment, and the remaining 40 (2.0%) were lost to follow-up. Of the 1958 infants followed up, CNLDO in 925 (47.3%) spontaneously resolved by age 3 months, in 1300 (66.4%) by 6 months, in 1472 (75.7%) by 9 months, and in 1516 (78.4%) by 12 months. The rate of resolution was 35% faster (95% CI, 23%-47%; P < .001) at less than 1 month vs 3 months, 43% faster (95% CI, 27%-64%; P < .001) at 3 months vs 6 months, 39% faster (95% CI, 16%-64%; P < .001) at 6 months vs 9 months, and 1% slower at 9 months vs 12 months (hazard ratio, 0.99; 95% CI, 0.80-1.22; P = .78). Congenital nasolacrimal duct obstruction resolved in boys 0.5 months (95% CI, 0.2-0.8; P < .001) faster than girls (median, 2.9 vs 3.4 months), and unilateral obstructions resolved 0.2 months (95% CI, 0.1-0.4; P = .002) faster than bilateral (median, 3.1 vs 3.3 months) ones. Children probed at 15 months or older had decreased odds of resolution after probing (odds ratio, 0.11; 95% CI, 0.01-0.89; P = .04) compared with children probed at age 12 to 14 months.Conclusions and relevanceBased on this large cohort of children with CNLDO, probing between age 9 and 15 months may be reasonable given that the rate of spontaneous resolution plateaued after 9 months and initial probing success declined after 15 months. This time frame supports both an earlier and narrower range of ages for intervention compared with the current practice of probing after age 1 year.

Project description:BackgroundStudies of local anatomic characteristics of primary acquired nasolacrimal duct obstruction (PANDO) are important for understanding the etiology of PANDO and guiding surgical treatment. The purpose of this study was to review computed tomography (CT) scans to identify the anatomic differences in the obstructed and unobstructed sides of PANDO patients as well as in control patients in a Chinese population.MethodsIn this retrospective comparative observational study, the CT scans of 126 PANDO patients were reviewed. A total of 76 patients who underwent CT examinations for eyeball atrophy or an intraocular foreign body but had a healthy lacrimal drainage system and orbit structure were enrolled as controls. The nasolacrimal canal (NLC) widths, lacrimal sac fossa structures, and nasal abnormalities in the obstructed and unobstructed sides in patients and both sides in controls were evaluated.ResultsBoth obstructed and unobstructed sides in PANDO patients showed significant differences to the sides of controls in NLC width (obstructed: 3.91±0.90 mm, unobstructed: 3.86±0.83 mm, control: 4.31±0.95 mm; obstructed and control: P<0.01, unobstructed and control: P<0.01, respectively), ethmoid sinusitis (26%, 28%, 16%; P=0.03 and P=0.03, respectively), osteomeatal complex opacification (18%, 14%, 7%; P<0.01 and P=0.04, respectively), and agger nasi cell opacification (22%, 20%, 9%; P<0.01 and P<0.01, respectively). However, although no significant differences (all P>0.05) were found between the obstructed and unobstructed sides of unilateral PANDO patients in these characteristics, there were correlations (r=0.714, 0.209, 0.376, and 0.112; P<0.01, P=0.03, P<0.01, P=0.24, respectively). We also found expanded lacrimal sac fossa width (6.45±1.01 mm) and decreased frontal process proportion (45.9%±15.4%) only in the obstructed sides of PANDO patients compared to the lacrimal sac fossa width in controls (6.08±1.16 mm, P<0.01) and the frontal process proportion in controls (49.9%±15.4%, P=0.03). There was no difference in the positional relationship of the uncinate process (UP) with the lacrimal fossa between patients and controls.ConclusionsA narrow NLC and nasal inflammation are associated with PANDO, while an expanded lacrimal sac fossa and a decreased frontal process proportion could be pathological changes. The healthy sides of unilateral PANDO patients might have a high risk of developing an obstruction. We also found an increased probability of the UP overlapping the lower lacrimal sac fossa in an Asian population compared to the published European data.

Dataset Information

Tsukamurella pulmonis conjunctivitis in patients with an underlying nasolacrimal duct obstruction - report of two cases.

Publications

<i>Tsukamurella pulmonis</i> conjunctivitis in patients with an underlying nasolacrimal duct obstruction - report of two cases.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets