Acute renal failure associated with nonfulminant hepatitis A virus infection

Hepatitis A is usually a mild self-limiting infection of the liver. Nonfulminant acute renal failure very rarely complicates type A viral hepatitis. An unusual case, a 32-year-old female with serologically proven acute hepatitis A infection, was complicated by acute renal failure and the patient in this study is the first case associated with Cushing's disease. She recovered, and the laboratory tests returned normal one month after initial hospitalization. Although the mechanism responsible for renal failure in acute hepatitis A virus infection is still uncertain, possible causes are discussed with the review of literature.     

Giant cell glioblastoma manifesting as traumatic intracerebral hemorrhage--case report

A 33-year-old male presented with intracerebral hemorrhage in the left temporoparietal region after a traffic accident. Ten months later, the traumatic hemorrhage was found to originate in an underlying giant cell glioblastoma. Our case indicates that non-traumatic underlying pathologies, such as vasculopathies, coagulopathies, or tumors, should be considered in the differential diagnoses of intracerebral hemorrhage occurring in unusual locations after traumatic accidents.     

The effects of caspofungin and voriconazole in experimental Candida endophthalmitis

PURPOSE: To evaluate the efficacy of newly developed antifungal agents caspofungin and voriconazole in Candida albicans endophthalmitis in rabbit eyes. METHODS: Thirty New Zealand white rabbits were divided into four treatment groups and one control group. One eye of each rabbit was infected by inoculation of 1 x 10(4) CFU/ml of C. albicans. Seventy-two hours after the inoculation, caspofungin 100 microg/0.1 ml in group 1 (n = 6), voriconazole 50 microg/0.1 ml in group 2 (n = 6), amphotericin B 10 microg/0.1 ml in group 3 (n = 6), itraconazole 10 microg/0.1 ml in group 4 (n = 6), and 0.1 ml NaCl 0.9% in control group (n = 6) were injected into the vitreous cavity. Clinical and histopathologic examination scores and microbiological analysis of vitreous aspirates were compared. RESULTS: There was statistically significant difference in the clinical scores, histopathologic scores, and mean CFU/ml between the treatment and control groups (p < 0.05). In caspofungin and voriconazole groups, histopathologic scores and mean CFU were lower than other treatment groups and control group. CONCLUSIONS: Intravitreal injection of caspofungin and voriconazole was effective against C. albicans endophthalmitis in this experimental rabbit model.     

Effects of intravitreal moxifloxacin and dexamethasone in experimental Staphylococcus aureus endophthalmitis

PURPOSE: To evaluate the effects of intravitreal moxifloxacin and moxifloxacin and dexamethasone combination in an experimental rabbit model of Staphylococcus aureus endophthalmitis. METHODS: The right eyes of 24 rabbits weighing 2 to 3 kg were used. Ten thousand colony-forming units (CFU) of S. aureus in 0.1 ml saline solution were inoculated into the vitreous cavity. The eyes were randomly assigned to one of the four groups equally. Twenty-four hours after the inoculation of S. aureus, group 1 received 50 microg moxifloxacin, group 2 received 50 microg moxifloxacin plus 400 microg dexamethasone, and group 3 received 1 mg vancomycin intravitreally. No treatment was given to group 4. Clinical examination scores were recorded. Vitreous aspirates were obtained for microbiological analysis just before sacrifice, and the eyes were enucleated for histopathologic examination. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests. RESULTS: In all treatment groups, mean number of CFU and histopathologic score were significantly lower compared with control group (p<0.05), and the difference between treatment groups was not statistically significant (p>0.05). The clinical score was not significantly different between groups (p>0.05). CONCLUSIONS: Intravitreal injection of 50 microg moxifloxacin was effective in the treatment of S. aureus endophthalmitis. Bacteriological, histopathologic, and clinical outcomes after treatment using moxifloxacin, moxifloxacin and dexamethasone combination, and vancomycin were comparable. Intravitreal moxifloxacin may be an option in the treatment of S. aureus endophthalmitis.     

Otitic hydrocephalus: role of radiology for diagnosis

OBJECTIVE: The pathogenesis of otitic hydrocephalus remains unclear. The use of radiological examination is very important to clarify both the diagnosis and the pathogenesis. In this article the role of magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) is discussed. PATIENTS: Two patients with the diagnosis of otitic hydrocephalus and their MRI and MRV findings are presented. RESULTS: Both of the patients presented had thrombus in their transverse sinuses pre-operatively demonstrated by MRI causing decreased flow on MRV. After the treatment blood flow through the sinus increased significantly as the symptoms subsided. CONCLUSION: MRI and MRV are valuable tools for diagnosis and follow-up of otitic hydrocephalus.     

Neonatal lupus erythematosus presenting with cholestatic hepatitis: a case report and review of the literature

Neonatal lupus erythematosus (NLE) is a disease primarily characterized by cardiac and/or cutaneous involvement. Hepatic, hematological, neurological and pulmonary involvement are rare manifestations and normally considered as mild and transient complications. But recent studies have shown more frequent hepatic involvement in NLE. We report a two month-old male infant, born to a clinically asymptomatic mother, presenting with significant hepatic involvement and annular, erythematous plaques with hyperkeratotic borders at the eyebrow region and anterior surface of trunk. Both the infant and his mother were positive for anti-Ro (SS-A) and anti-La (SS-B).