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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.edu

Gabriela Sanchez Petitto et al., J Infect Dis Ther 2016, 4:4(Suppl)

http://dx.doi.org/10.4172/2332-0877.C1.009