Eduardo A Novais1, Alessandra G Commodaro2, Fábio Santos3, Cristina Muccioli1, André Maia1, Heloisa Nascimento1, Cecilia T A Moeller1, Luiz V Rizzo4, Michael E Grigg5, Rubens Belfort1. 1. Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil. 2. Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA. 3. Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil Hospital Albert Einstein, São Paulo, São Paulo, Brazil. 4. Hospital Albert Einstein, São Paulo, São Paulo, Brazil. 5. Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
Abstract
BACKGROUND/AIMS: To determine if patients with inactive chorioretinitis lesions who experience chronic toxoplasmic uveitis test PCR positive for Toxoplasma in their ocular fluids. METHODS: Two patients undergoing long-term anti-toxoplasmic treatment developed chronic uveitis and vitritis. They underwent therapeutic and diagnostic pars plana vitrectomy. Patient specimens were tested for toxoplasmosis by real-time PCR and nested PCR. Patient specimens were also tested for the presence of Toxoplasma antibodies that recognise allelic peptide motifs to determine parasite serotype. RESULTS: Patients tested positive for Toxoplasma by real-time PCR at the B1 gene in the vitreous and aqueous humours of patient 1, but only the vitreous of patient 2. Patients were not parasitemic by real-time PCR in plasma and blood. During surgery, only old hyperpigmented toxoplasmic scars were observed; there was no sign of active retinitis. Multilocus PCR-DNA sequence genotyping at B1, NTS2 and SAG1 loci established that two different non-archetypal Toxoplasma strains had infected patients 1 and 2. A peptide-based serotyping ELISA confirmed the molecular findings. CONCLUSIONS: No active lesions were observed, but both patients possessed sufficient parasite DNA in their vitreous to permit genotyping. Several hypotheses to explain the persistence of the vitritis and anterior uveitis in the absence of active retinitis are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND/AIMS: To determine if patients with inactive chorioretinitis lesions who experience chronic toxoplasmic uveitis test PCR positive for Toxoplasma in their ocular fluids. METHODS: Two patients undergoing long-term anti-toxoplasmic treatment developed chronic uveitis and vitritis. They underwent therapeutic and diagnostic pars plana vitrectomy. Patient specimens were tested for toxoplasmosis by real-time PCR and nested PCR. Patient specimens were also tested for the presence of Toxoplasma antibodies that recognise allelic peptide motifs to determine parasite serotype. RESULTS:Patients tested positive for Toxoplasma by real-time PCR at the B1 gene in the vitreous and aqueous humours of patient 1, but only the vitreous of patient 2. Patients were not parasitemic by real-time PCR in plasma and blood. During surgery, only old hyperpigmented toxoplasmic scars were observed; there was no sign of active retinitis. Multilocus PCR-DNA sequence genotyping at B1, NTS2 and SAG1 loci established that two different non-archetypal Toxoplasma strains had infectedpatients 1 and 2. A peptide-based serotyping ELISA confirmed the molecular findings. CONCLUSIONS: No active lesions were observed, but both patients possessed sufficient parasite DNA in their vitreous to permit genotyping. Several hypotheses to explain the persistence of the vitritis and anterior uveitis in the absence of active retinitis are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Diagnostic tests/Investigation; Immunology; Infection; Inflammation; Treatment Surgery
Authors: Jean D Vaudaux; Cristina Muccioli; Erick R James; Claudio Silveira; Spencer L Magargal; Calvin Jung; J P Dubey; Jeffrey L Jones; Mehmet Z Doymaz; David A Bruckner; Rubens Belfort; Gary N Holland; Michael E Grigg Journal: J Infect Dis Date: 2010-10-15 Impact factor: 5.226
Authors: Deise F Costa; Heloisa Nascimento; Aline Sutili; Fernando A J Nobrega; Flavio Fowler; Mario Junqueira Nobrega; Cristina Garrido; Janaina de Oliveira Dias; Consuelo B D Adán; Luiz Vicente Rizzo; Claudio Silveira; Rubens Belfort; Alessandra G Commodaro Journal: Parasitol Res Date: 2017-05-15 Impact factor: 2.289