A 10-year-old girl presented with esotropia. She had 35 prism diopters of esodeviation at far and near with left inferior oblique muscle overaction (+3). Cycloplegic refraction was +0.5D OD and +0.75D OS, and visual a...A 10-year-old girl presented with esotropia. She had 35 prism diopters of esodeviation at far and near with left inferior oblique muscle overaction (+3). Cycloplegic refraction was +0.5D OD and +0.75D OS, and visual acuity was 20/25 in each eye. The patient was being treated with G-CSF (Leufokine?) due to her severe congenital neutropenia (WBC 3350, neutrophil 7.3%, and ANC 170/ul). Despite of low ANCs, we decided to perform a surgery because the patient and her parents strongly wanted it. Prophylactic topical antibiotics (Cravit?, levofloxacin 0.5%) were applied four times a day for three days prior to the surgery. We sterilized the periocular skin with povidone-iodine 10% and placed povidone-iodine 5% drops in the cul-de-sac preoperatively. Strabismus surgery was performed. After surgery, profuse irrigation with the entire bottle of topical antibiotics (Vigamox?, moxifloxacin hydrochloride 0.5%) was performed for each eye. We prescribed topical and highly potent systemic antibiotics for 1 week. This is the first case report to describe the successful perioperative antisepsis care following strabismus surgery for a patient with severe congenital neutropenia. Prevention of postoperative infection in granulocytopenic patients could be achieved using antibiotic agents which provide the greatest spectrum of coverage against both Gram-positive and Gram-negative infections.展开更多
Kostmann syndrome, or severe congenital neutropenia, is a rare condition in children marked by a neutrophil count of less than 500/mm3. This congenital agranulocytosis, an autosomal recessive genetic disorder, is ofte...Kostmann syndrome, or severe congenital neutropenia, is a rare condition in children marked by a neutrophil count of less than 500/mm3. This congenital agranulocytosis, an autosomal recessive genetic disorder, is often first identified by a neonatal infectious syndrome. The deficiency in neutrophils increases susceptibility to bacterial and fungal infections. Prior to the availability of hematopoietic growth factors, the disease was associated with significant morbidity and early mortality. We present the case of a 17-month-old boy who was admitted to the pediatric emergency department at Hassan II University Hospital in Fes with skin abscesses.展开更多
文摘A 10-year-old girl presented with esotropia. She had 35 prism diopters of esodeviation at far and near with left inferior oblique muscle overaction (+3). Cycloplegic refraction was +0.5D OD and +0.75D OS, and visual acuity was 20/25 in each eye. The patient was being treated with G-CSF (Leufokine?) due to her severe congenital neutropenia (WBC 3350, neutrophil 7.3%, and ANC 170/ul). Despite of low ANCs, we decided to perform a surgery because the patient and her parents strongly wanted it. Prophylactic topical antibiotics (Cravit?, levofloxacin 0.5%) were applied four times a day for three days prior to the surgery. We sterilized the periocular skin with povidone-iodine 10% and placed povidone-iodine 5% drops in the cul-de-sac preoperatively. Strabismus surgery was performed. After surgery, profuse irrigation with the entire bottle of topical antibiotics (Vigamox?, moxifloxacin hydrochloride 0.5%) was performed for each eye. We prescribed topical and highly potent systemic antibiotics for 1 week. This is the first case report to describe the successful perioperative antisepsis care following strabismus surgery for a patient with severe congenital neutropenia. Prevention of postoperative infection in granulocytopenic patients could be achieved using antibiotic agents which provide the greatest spectrum of coverage against both Gram-positive and Gram-negative infections.
文摘Kostmann syndrome, or severe congenital neutropenia, is a rare condition in children marked by a neutrophil count of less than 500/mm3. This congenital agranulocytosis, an autosomal recessive genetic disorder, is often first identified by a neonatal infectious syndrome. The deficiency in neutrophils increases susceptibility to bacterial and fungal infections. Prior to the availability of hematopoietic growth factors, the disease was associated with significant morbidity and early mortality. We present the case of a 17-month-old boy who was admitted to the pediatric emergency department at Hassan II University Hospital in Fes with skin abscesses.
