Bilateral Hypopyon Research Articles

Bilateral hypopyon uveitis in carcinoma of breast: Masquerade syndrome and review of literature

Maquerade syndromes are a group of ocular diseases that mimic inflammation but are due to neoplastic or less commonly non- neoplastic diseases. Metastatic choroidal disease is the most frequent clinical feature in carcinoma breast. We report a rare presentation of simultaneous uveal and orbital involvement in a 60- year-old lady with invasive ductal carcinoma. She had masquerade syndrome with acute hypopyon uveitis, angle closure glaucoma and panophthalmitis due to breast carcinoma. Anterior uveitis was due to an immune response which rapidly progressed to panophthalmitis because of orbital metastasis.

Hypopyon uveitis as a presenting manifestation of biopsy-proven sarcoidosis – A case report

A 68-year-old lady was referred for evaluation of bilateral hypopyon uveitis by her ophthalmologist. She had a history of bilateral cataract surgery 8 months ago and had received intravitreal dexamethasone implants for recurrent bouts of anterior uveitis with cystoid macular edema (CME) in both eyes 4 months ago. Systemic history was significant for diabetes mellitus and recurrent skin lesions. Aqueous tap was negative for infection on culture and polymerase chain reaction (PCR). Skin biopsy showed non-necrotizing granulomas, negative for Mycobacterium tuberculosis and fungi, suggestive of sarcoidosis. She received oral steroids and methotrexate, which resulted in resolution of ocular and skin lesions. This case highlights a rare presentation of hypopyon in ocular sarcoidosis.

Bilateral hypopyon corneal ulcers in pancreatic carcinoma

A 39-year-old woman on palliative chemotherapy for pancreatic carcinoma presented with painful bilateral vision loss. On examination, she had large bilateral corneal ulcers with hypopyon, with corneal and conjunctival xerosis. She was extremely malnourished. Investigations revealed macrocytic anemia with pancytopenia and hypoproteinemia suggestive of pancreatic enzyme insufficiency (PEI). Microbiology reported Pseudomonas aeruginosa infection that was sensitive to ceftazidime. Treatment with topical ceftazidime and oral vitamin A and B12 supplementation (therapeutic doses) led to rapid resolution of the ulcers in 4 weeks. Xerophthalmia with secondary keratitis due to malnutrition from pancreatic carcinoma is hitherto unreported but can be treated successfully with timely identification.

Topiramate induced bilateral hypopyon uveitis and choroidal detachment: a report of two cases and review of literature

BackgroundTopiramate (TPM) is a drug commonly used by neurophysicians and psychiatrists for a plethora of indications. Topiramate has been reported to induce acute angle closure glaucoma as an adverse effect. However, there is limited literature on Topiramate causing hypopyon uveitis and intense ocular inflammation. It is imperative for ophthalmologists as well as physicians to be aware of the potential sight threatening ocular adverse effects of Topiramate. We report 2 rare consecutive cases of severe hypopyon uveitis and choroidal detachments after using Topiramate.Case presentationTwo patients presented with sudden onset of angle closure, bilateral hypopyon uveitis and choroidal detachments. On reassessing a detailed treatment history, it was found that both patient were taking oral Topiramate which had been started 2 weeks before the onset of ocular symptoms. The bilateral hypopyon and angle closure were considered to be induced by Topiramate and the drug was discontinued. The patients were started on oral and topical steroids which led to resolution of hypopyon uveitis and choroidal detachments. The visual acuity improved and the intraocular pressure also got normalised in both the cases.ConclusionsTopiramate can lead to a bilateral hypopyon uveitis and severe ocular inflammation. An urgent cessation of topiramate along with topical and systemic steroids is required to prevent serious complications.

Neurological symptoms and mortality associated with Streptococcus gallolyticus subsp. pasteurianus in calves

Suppurative meningitis-meningoencephalitis (M-ME) is a sporadic disease in neonatal ungulates and only a few studies have reported the involvement of Streptococcus bovis/Streptococcus equinus complex (SBSEC) members in bovine neonatal M-ME. The SBSEC taxonomy was recent revised and previous biotype II/2 was reclassified as S. gallolyticus subsp. pasteurianus (SGP). The aim of this study was to describe a case of fatal neonatal neurological syndrome associated with SGP in calves. Ten calves were monitored because of neurological hyperacute symptoms associate with bilateral hypopyon and death. They were not fed with maternal colostrum; two of them died and were subjected to bacteriological, histopathological and biomolecular analysis as well as antibiotic susceptibility test. Both animals presented lesions mostly concentrated to meninges and brain and had bilateral hypopyon. Nine strains isolated in purity from brain, ocular humors and colon were identified as S. bovis group by using the API Strep system and as S. gallolyticus by using the 16S rRNA sequence. Two of these strains where subjected to WGS analysis that confirmed the sub-species identification and the clonality of the two SGP strains. The strains were found resistant to OT, SXT, MTZ and EN and susceptible to AMP, AMC, KZ and CN. We hypothesized that the syndrome observed could be due to the lack of maternal colostrum feeding. A timely and precise diagnosis could have likely prevented the death of the calves and, since the zoonotic potential of SBSECs members is known, accurate and rapid identification is required.

Citrobacter koseri Septicaemia in a Holstein Calf

A 4-day-old male Holstein calf with dull mentation, nystagmus and blindness was humanely destroyed and subject to necropsy examination. Gross lesions included severe suppurative meningitis characterized by diffuse cloudy thickening of the meninges, bilateral hypopyon and fibrinosuppurative polyarthritis affecting the hocks. Citrobacter koseri was isolated from the meninges, ocular fluid, synovial fluid, spleen and small intestine. Microscopically, there was neutrophilic and histiocytic meningitis with intralesional bacilli, endophthalmitis, neutrophilic splenitis and multiple renal microabscesses. Failure of passive transfer of colostrum was confirmed. This appears to be the first characterization of septicaemia in a calf caused by C. koseri, with lesions comparable with those described in human neonates.

Bilateral hypopyon and vitritis associated with rifabutin therapy in an immunocompetent patient taking itraconazole

Bilateral hypopyon and vitritis associated with rifabutin therapy in an immunocompetent patient taking itraconazole

Acute bilateral hypopyon in acute lymphocytic leukaemia

Acute lymphocytic leukaemia (ALL) is a malignant clonal disorder of the bone marrow lymphopoietic precursor cells, characterized by accumulation of lymphoblasts that lack the potential for differentiation and maturation [1]. These abnormal cells spill into the circulation and infiltrate other organs such as the liver, spleen, central nervous system (CNS) and the eye. Presence of intraocular leukaemic infiltrates correlates with CNS involvement and with decreased survival [2, 3]. Ocular manifestation may be the only sign of leukemic relapse or may present several months prior to systemic relapse. Hence, prompt anterior chamber aspiration is required for the correct diagnosis and treatment.

Bilateral Hypopyon as the Presenting Feature of Chronic Myeloid Leukemia

Purpose: To report bilateral hypopyon as an unusual presenting feature of chronic myeloid leukemia (CML). Design: Observational case report. Methods: A 68-year-old male presenting with bilateral hypopyon uveitis underwent hematological investigations and cytology of hypopyon. Results: Blood smear revealed increased leucocyte count with presence of abnormal cells (myelocytes, band forms, and promyelocytes) suggestive of CML. Cytopathology of hypopyon revealed predominance of lymphocytes and few plasma cells. CML was confirmed by hematological investigations. Patient was initiated on chemotherapy under the care of an oncologist and is stable. Conclusions: Elderly patients presenting with hypopyon uveitis should be investigated to rule out masquerade syndrome.

Hypopyon uveitis and relapsing polychondritis: A report of 2 patients and review of autoimmune hypopyon uveitis

Objective To report hypopyon uveitis as an ophthalmic finding associated with relapsing polychondritis. Design Interventional case reports. Participants Two patients with hypopyon uveitis as a manifestation of relapsing polychondritis. Methods Complete ocular and systemic examinations as well as chart reviews were performed for 2 patients with hypopyon uveitis as a manifestation of relapsing polychondritis at presentation. Main outcome measurements Clinical observation and response to treatment in 2 patients with hypopyon uveitis secondary to relapsing polychondritis. Results A 70-year-old white male had unilateral hypopyon uveitis accompanied by a migratory polyarthralgia at presentation. Fifteen months later, he sought treatment for chondritis of the right auricle and was diagnosed with relapsing polychondritis. A 42-year-old white female with known relapsing polychondritis had bilateral hypopyon uveitis at presentation during a systemic relapse. Both patients had resolution of the hypopyon with topical and systemic steroids. Conclusions Relapsing polychondritis should be considered in the differential diagnosis of sterile hypopyon uveitis. Steroids and systemic immunosuppression can be used to treat the uveitis.

Bilateral hypopyon iritis in a patient with diabetes mellitus

A 47-year-old man with diabetes mellitus complained of decreased vision and ocular pain in his right eye. On examination, hypopyon was found in that yee. He also had compound periodontitis. Six days later, hypopyon developed in the left eye. After topical instillation of betamethasone, ofloxacin, and atropine, the bilateral hypopyon iritis decreased. we suggest that an acute bacterial infection in patients with diabetes mellitus may lead to hypopyon iritis.