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      A Case of Extrusion of a Solid Silicone Tire Migrating through the Superior Rectus Muscle with Aeromonas hydrophila Infection following a Scleral Buckling Procedure

      case-report
      * ,
      Case Reports in Ophthalmological Medicine
      Hindawi Publishing Corporation

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          Abstract

          To our knowledge, there are no reports of Aeromonas hydrophila infection after a scleral buckling procedure. Also, migration of a silicone explant element through the rectus muscles is extremely rare. Herein, we describe a case experiencing extrusion of a solid silicone tire migrating through the superior rectus muscle with Aeromonas hydrophila infection following a scleral buckling procedure. A 42-year-old man was referred to our hospital complaining of ocular pain and purulent discharge in his left eye which has persisted for several months. He had a history of bilateral rhegmatogenous retinal detachment which had been treated with scleral buckling. The left eye showed extrusion of the solid silicone buckle which had migrated through the superior rectus muscle and an infection in the upper quadrant of the sclera. The buckle was removed, and the patient was treated with antibiotics. After the removal of the buckle, the symptoms showed rapid amelioration and there was no recurrence of retinal detachment. Aeromonas hydrophila was isolated from the discharge and the removed explant. He used well water in daily life. In this case, the Aeromonas hydrophila infection of the extruded buckle might have originated from contaminated well water.

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          Most cited references30

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          Recent advances in the study of the taxonomy, pathogenicity, and infectious syndromes associated with the genus Aeromonas.

          J. Janda (1991)
          Over the past decade, the emergence of Aeromonas species as bona fide human pathogens and their probable role as etiologic agents of bacterial gastroenteritis have resulted in an explosion of scientific interest in the genus. Major accomplishments occurring in this field during that interval include a more refined taxonomy, identification of new cell-associated factors (surface layers, pili), and the molecular analysis of selected extracellular gene products that may play a critical role in pathogenesis (hemolysins, enterotoxins). This review provides an updated overview of recent systematic, clinical, and pathophysiologic advances and defines key areas of medical and scientific interest in which major questions remain unanswered.
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            Erosion and intrusion of silicone rubber scleral buckle. Presentation and management.

            To describe the clinical presentation and management of erosion and intrusion of silicone rubber implants that are used in scleral buckling procedures for the treatment of retinal detachment. The authors identified four patients from their practices during the last 20 years (1978-1998) who had erosion or intrusion of silicone rubber scleral buckles that were used to manage retinal detachment. Approximately 4400 scleral buckling procedures were performed during this period. A retrospective review of the medical records of all patients was performed. Factors that influenced management decisions concerning the intruding buckle are emphasized. All four patients had myopia. The interval between placement of the scleral buckle and development of intrusion ranged from 1 to 20 years. The buckles were intrascleral in three cases and episcleral in one. Recurrent detachment and vitreous hemorrhage were indications for surgical intervention in three cases. After the surgical removal of buckling elements, visual acuity stabilized in all patients and the retina remained attached in all cases. Erosion and intrusion of scleral buckle are rare complications of scleral buckling procedures. The intruding buckle may be left intact unless there is significant threat to the integrity of ocular structures, recurrent detachment, or hemorrhage. Manipulation of the encircling band or buckle does not necessarily alter the visual acuity or the status of the retina.
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              Bilateral endogenous endophthalmitis caused by Aeromonas hydrophila.

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                Author and article information

                Journal
                Case Rep Ophthalmol Med
                Case Rep Ophthalmol Med
                CRIM.OPHMED
                Case Reports in Ophthalmological Medicine
                Hindawi Publishing Corporation
                2090-6722
                2090-6730
                2012
                20 November 2012
                : 2012
                : 167164
                Affiliations
                Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Tochigi, Shimotsuke 329-0498, Japan
                Author notes

                Academic Editors: H. Atilla, H. Y. Chen, and E. Chihara

                Article
                10.1155/2012/167164
                3508534
                23213585
                a9d6e355-9fd3-4ad6-8fc8-81d75731deca
                Copyright © 2012 S. Makino and Y. Sato.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 October 2012
                : 31 October 2012
                Categories
                Case Report

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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