Coinfections and differential diagnosis in immunocompetent patients with uveitis of infectious origin

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 traditi...

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Autores:
Tipo de recurso:
Fecha de publicación:
2019
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/23566
Acceso en línea:
https://doi.org/10.1186/s12879-018-3613-8
https://repository.urosario.edu.co/handle/10336/23566
Palabra clave:
Antiinflammatory agent
Antiparasitic agent
Antiretrovirus agent
Immunomodulating agent
Tuberculostatic agent
Valganciclovir
Virus dna
Adolescent
Adult
Aged
Aqueous humor
Article
Blood sampling
Clinical examination
Colombia
Colombian
Cytomegalovirus infection
Descriptive research
Diagnostic test
Differential diagnosis
Drug substitution
Drug withdrawal
Epstein barr virus infection
Female
Goldmann witmer coefficient
Herpes simplex virus 2
Herpes zoster
Herpes zoster ophthalmicus
Human
Human alphaherpesvirus 1
Immunocompetence
Laboratory test
Major clinical study
Male
Mixed infection
Nonhuman
Ocular toxoplasmosis
Ocular tuberculosis
Polymerase chain reaction
Serum
Uveitis
Vitreous body
Complication
Cytomegalovirus
Differential diagnosis
Genetics
Herpes virus infection
Immunocompetence
Immunology
Middle aged
Mixed infection
Parasitic eye infection
Toxoplasmosis
Viral eye infection
Virology
Young adult
Adolescent
Adult
Aged
Coinfection
Colombia
Cytomegalovirus
Female
Herpesviridae infections
Humans
Immunocompetence
Male
Middle aged
Polymerase chain reaction
Toxoplasmosis
Young adult
Co-infections
Diagnosis
Goldmann-witmer
Immunocompetent
Ocular toxoplasmosis
Pcr
viral
differential
parasitic
viral
Diagnosis
Dna
Eye infections
Eye infections
Rights
License
Abierto (Texto Completo)
Description
Summary: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. © 2019 The Author(s).