Hospital Violence By Violation

(MYCOTIC KERATITIS, KERATOMYCOSIS)
contraception Keratitis is considered an opportunistic disease. The disease was first described by Leber in 1879 in a farmer suffering from anterior purulent infection caused by keratitis after being shredded into the eye by the rice husk fragments and the pathogen identified as the fungus Aspergillus glaucus. The incidence of the disease is increasing due to the widespread use of antibiotics and corticoides.
1. Epidemiology
The disease is found everywhere, kkha1 is common in our country (25% of cases of corneal ulcers in the North)

. The disease usually occurs in those who work in agriculture (farming, fields, fruit picking ..) or those who have to work outdoors such as rock dams, irrigation .



.. Adults, especially men, account for the majority of cases. sick. Infection frequency varies by season and by region.
In Southern Florida, the disease decreases during hot, humid, and rainy months (June - September); increase in the dry and windy season (October - March) because the dry climate will help the spores release into the air more easily and the wind will increase the risk of dust coming into eyes.
In West & South America, the disease increases in the summer and fall because people go out, the risk of foreign bodies in the eyes increases so the risk of exposure to the fungus increases
The disease usually occurs after an eye injury that damages the corneal epithelial layer from which the fungus is easily invaded:
Scratches by foreign objects in the eyes such as rice leaves scratching the cornea or husk, sandy soil, metal shrapnel .. shot in the eyes.



.
Eye diseases such as dry eye, herpes simplex keratitis, cornow boils (bullow keratopathy) ...
Wear contact lenses (contact lens)
The eye surgery.
Using antibacterial antibiotics, corticosteroids ophthalmic will develop permanent fungal spores in the eye and decrease the host's immune response to the presence of fungal spores.
Pathogens:
More than 60 species of fungi can cause keratitis, including very rare species that cause disease in other sites. The most common fungi are Fusarium solani, Aspergillus, Curvularia.
Candida sp., Rhizopus sp.



., Blastomyces dermatitidis, Sporothrix schenckii, Cryptococcus neoformans and Coccidiodes immitis often cause endophthlmitis caused by blood-borne fungal infections or due to the spread of fungal bacterial foci on skin. The face and sinuses are close However, the disease may occur primarily due to Blanstomyces dermatitidis and Crytococcus neoformans that are of an extrinsic origin or from an infected corneal transplant.
Most pathogenic fungi are available in soil and plants. They are also found permanently on the eyes (eyelids, conjunctiva ...) healthy people (6% - 25%). Therefore, it is thought that resident fungi around the eye are sources of fungal keratitis as well as postoperative endophthalmitis.
2.



CLINICAL
Although there are many types of fungi that cause disease, the clinical manifestations are the same.
Most diseases occur after an eye injury about 1-2 days. The patient experiences burning pain, severe pain in the eye, fear of light, red eyes and reduced vision.
Initially a tear in the corneal epithelium and Bowman membrane, gradually becomes a small gray-white tumor on the cornea, then the surrounding cornea liquefies to create an ulcer:
The surface is dry, quite high.
Lesions are clearly limited, but the sores have ray-like rays.
Surrounded and at the bottom of the ulcer are the macula, a dense, white, or yellowish infiltrate that penetrates the connective tissue (stroma).
Satellites (satellite lesions or "ring abscesses") appear gradually around the central ulcer.
Connective tissue with edema
Descemet membranes may be wrinkled.
Conjunctival hyperemia, sometimes edema.



.
Premature affected room can progress to anterior pus (hypopyon) but completely incompatible and may occur before corneal perforation. The tissue around the eyeball is not invasive but the injured eye may be removed by pain. The ulcer spreads faster if the eye drops with antibiotics and corticoides.
In Vietnam, two quite specific ulcers are:
Ulcers close the surface, easily peeled to pieces.
Central abscess ulcer, surrounded by an abscess ring, dry surface.
Bad prognosis when the ulcer is too extensive and purulent for aphrodisiac Perforation of the cornea, pyoderma and perianal infection can occur with treatment. Corneal scars and vision loss are common sequelae.
Differential diagnosis
Ulcer caused by frequent corneal exposure when eye nerve paralysis.
Mooren Ulet.



.
Corneal bullous disease after chronic glaucoma
Implementing the quadrants.
It is clinically difficult to distinguish fungal keratitis from viral, bacterial or Acanthamoeba keratitis. Manifestations such as a history of anomalies in the eye, although it is not clear what the object is, anterior chamber pus occurs early, there are satellite lesions suggested by the fungus, but it is best to rely on a test for finding fungi in specimens.
Collect specimens
Corneal secretions, jaundice, etc are not valid for diagnosis because there are strains of fungi resident on the face and around the eyes that cause false positives.
Anterior chamber pus is usually sterile so it is not a good specimen to transplant. In addition, sucking room money can cause dangerous disasters.
Best specimen.

. Dịch vụ: Thiết kế website, quảng cáo google, đăng ký website bộ công thương uy tín