Coinfections and differential diagnosis in immunocompetent patients with uveitis of infectious origin
| Autor: | Felipe Durán, Elizabeth Torres-Morales, Clara López de Mesa, Jessica Triviño, Juan David Zuluaga, Andrés Uauy-Nazal, Alejandra de-la-Torre, Lina María Ramírez-Páez, Juan Carlos Sepúlveda-Arias, Mateo Murillo, Alba Cristina Peñaranda, Juanita Valdes-Camacho, Jorge Enrique Gómez-Marín |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Serum Viral eye infection Polymerase Chain Reaction 0302 clinical medicine Valganciclovir Eye Infections Parasitic Epstein barr virus infection Human alphaherpesvirus 1 Goldmann-Witmer Coinfection Herpesviridae Infections Diagnostic test Polymerase chain reaction Colombian Pcr PCR Virus dna Goldmann witmer coefficient Tuberculostatic agent Aqueous humor Human viral Immunomodulating agent medicine.medical_specialty differential Tuberculosis Immunology 030106 microbiology Major clinical study Colombia Article lcsh:Infectious and parasitic diseases Drug substitution 03 medical and health sciences Descriptive research Antiinflammatory agent Genetics Humans Antiretrovirus agent Aged parasitic Dna medicine.disease Toxoplasmosis Parasitic eye infection Herpes zoster ophthalmicus DNA Viral Differential diagnosis Complication Herpes virus infection 0301 basic medicine Blood sampling Ocular tuberculosis Herpes zoster Eye Infections Viral Cytomegalovirus Clinical examination Ocular toxoplasmosis medicine.disease_cause Medical microbiology Diagnosis Mixed infection Herpesviridae infections 030212 general & internal medicine Middle aged Drug withdrawal Herpes simplex virus 2 Middle Aged Goldmann-witmer Cytomegalovirus infection Infectious Diseases Female Immunocompetence Uveitis Research Article Adult Laboratory test Adolescent Virus Diagnosis Differential Young Adult Virology medicine lcsh:RC109-216 Vitreous body Antiparasitic agent Co-infections business.industry Varicella zoster virus Nonhuman Dermatology Young adult Eye infections Immunocompetent business |
| Zdroj: | BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-10 (2019) Repositorio EdocUR-U. Rosario Universidad del Rosario instacron:Universidad del Rosario BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-018-3613-8 |
| Popis: | Background Making a definite diagnosis of infectious uveitis is a challenging task because many other infectious, and non-infectious uveitis, may have similar non-specific symptoms and overlapping clinical appearances. Co-infections in immunocompetent patients are not frequently proved with traditional serologic-diagnostic tools. Methods Descriptive transversal study, in a Uveitis Service of an Ophthalmology Reference Center, in Bogotá, Colombia, from July 2014 to February 2016. Aqueous humor (AH) and/or vitreous fluid, blood and serum samples were collected from consecutive patients suspected of having infectious uveitis. The diagnosis of ocular toxoplasmosis (OT) was confirmed by the Goldmann–Witmer coefficient (GWC) and by polymerase chain reaction (PCR). Differential diagnosis by PCR in AH was done for viral origin such as Cytomegalovirus (CMV), Herpes simplex virus type 1 (HSV1), Herpes simplex virus type 2 (HSV2), Varicella zoster virus (VZV), Epstein-Barr virus (EBV) and Mycobacterium tuberculosis. Results In 66 Colombian patients with uveitis of presumed infectious origin: 22 (33.3%) were confirmed as OT, 16 (24.2%) as undetermined OT, five (7.5%) as co-infections and 23 (34.8%) as other uveitis. Toxoplasma coinfection with M. tuberculosis was identified in one case by PCR and in four cases with HSV by GWC. The initial clinical diagnosis changed, after laboratory examination, in 21 cases (31.8%). Conclusions Clinical diagnosis can be changed by laboratory examination in a significant proportion of cases of uveitis. Diagnosis of OT should combine the use of PCR and GWC to reach the maximum of confirmation of cases. The use of multiple laboratory methods is necessary to identify co-infections and viral infections that can mimic OT in immunocompetent patients. Electronic supplementary material The online version of this article (10.1186/s12879-018-3613-8) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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