

Volume 4, Issue 4(Suppl)
J Infect Dis Ther 2016
ISSN: 2332-0877, JIDT an open access journal
Page 97
Notes:
Infectious Diseases 2016
August 24-26, 2016
conferenceseries
.com
August 24-26, 2016 Philadelphia, USA
&
Infectious Diseases
Joint Event on
2
nd
World Congress on
Pediatric Care & Pediatric Infectious Diseases
International Conference on
Significanceofpolymerasechainreaction(PCR)analysisofvitreoushumorinanimmunocompromised
patient with necrotizing retinochoroiditis
Gabriela Sanchez Petitto, Astrid Serauto, Min Ji Kwak
and
Gabriel Aisenberg
University of Texas Health Science Center at Houston, USA
A
36-year-old woman with newly diagnosed nephrotic syndrome presented with a 10-day history of progressive vision loss. On
ophthalmological exam, visual acuity was 20/800 in both eyes. The left eye showed grade 4 disc edema and both retina had
vitreous and intraretinal hemorrhages. HIV serology was positive, CD4 count of 17/ul and viral load of 375000 copies/ml, newly
diagnosed. CT head was normal. Cerebrospinal fluid analysis is unremarkable. Serum and CSF immunoglobulins against
Toxoplasma
spp., PCR for herpes simplex virus 1 and 2, varicella-zoster (VZV) and
Cytomegalovirus
(CMV) were negative. Empirical ganciclovir,
trimethoprim-sulfamethoxazole and prednisolone were started. Vitreal fluid extracted by paracentesis was positive for toxoplasma
antigen and negative for CMV and VZV in both eyes. The diagnosis of toxoplasma retinochoroiditis was confirmed. The patient
continued a 6-week course of antibiotics with clinical improvement at 4 weeks. In immunocompromised patients is difficult to
establish a diagnosis of ocular toxoplasmosis based upon the lesions’ appearance, since atypical lesions are common and obtaining
reliable results for immunodiagnostic assays is more difficult. The best clue to diagnosis is recognition of the clinical presentation and
the detection of the agent in ocular samples by molecular biology. Confirmation of diagnosis is higher for PCR of vitreous samples
compared to aqueous humor; this due to the fact that, anatomically the vitreous humor is closest to the necrotic lesions, leading to
a better sampling of the parasitic DNA. In summary, a positive PCR study for
T. gondii
became a dependable alternative to diagnose
retinochoroiditis in an immunocompromised patient.
Biography
Gabriela Sanchez Petitto has completed her MD from the Universidad Central de Venezuela, School of Medicine. She is currently a Postgraduate student of Internal
Medicine at the University of Texas Health Science Center at Houston. She has worked in several projects with hematological malignancies and in the upcoming future with
antibiotic resistance projects.
Gabriela.SanchezPetitto@uth.tmc.eduGabriela Sanchez Petitto et al., J Infect Dis Ther 2016, 4:4(Suppl)
http://dx.doi.org/10.4172/2332-0877.C1.009