Identification ofLeptospiraSpecies in the Pathogenesis of Uveitis and Determination of Clinical Ocular Characteristics in South India

Abstract

Uveitis is considered a rare complication of leptospirosis. This report describes an epidemic of uveitis among patients with leptospirosis and provides data, using polymerase chain reaction (PCR) amplification of Leptospira DNA, that the pathogenesis is associated with anterior chamber spirochetes. Forty-six uveitis patients, 49 uveitis controls, and 54 cataract controls were enrolled at Aravind Eye Hospital (Madurai, India). Leptospiral DNA was detected by PCR of aqueous humor; serum antibody titers were determined by ELISA and microagglutination (MAT). Thirty-seven uveitis patients (80%) demonstrated leptospiral DNA compared with 5 controls (8%; P < .001). Thirty-three uveitis patients (72%) had positive serology compared with 10 uveitis controls (20%) and 13 cataract controls (24%; P < .001). This report describes the largest cluster of patients with leptospiral uveitis and identifies six clinical characteristics that provide a diagnostic profile for leptospiral uveitis. This profile will be important for determining treatment regimens in countries where PCR and MAT are not available.

Identification and evaluation of LPS antigen for serodiagnosis of uveitis associated with leptospirosis

“…This form of uveitis typically manifests as acute non-granulomatous, diffuse uveitis involving one or both eyes (Rathinam et al, 1997). An elevated antibody titre to leptospires by microscopic agglutination test (MAT) and the detection of leptospiral DNA in the anterior chamber fluid of uveitis patients suggested a possible leptospiral aetiology (Chu et al, 1998).…”

Host-Inducible Immunogenic Sphingomyelinase-Like Protein, Lk73.5, ofLeptospira interrogans

“…Symptoms of infection vary from subclinical to potentially fatal with multiorgan involvement (30,38,50). Immune-based uveitis leading to blindness (12,26,40,51) is a devastating sequela in humans and horses. Survival of the organism in water and persistent urinary shedding by wildlife, rodents, and livestock complicate control of the disease (30,50).…”

Leptospirosis: Puesta al día

“…En pacientes con compromiso hepático y meníngeo suele observarse el hecho, excepcional en el adulto, de xantocromía debida a presencia de pigmentos biliares en LCR. [26][27][28][29] , incluso en seis pacientes tratados con antimicrobianos, y desde antes del 8º día de evolución 37 . En 1993, Merien y cols, comunicaron el primer caso de uveítis con RPC positiva para Leptospira sp en humor acuoso 38 .…”