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Published in: Journal of Ophthalmic Inflammation and Infection 1/2018

Open Access 01-12-2018 | Brief report

Toxoplasma gondii bradyzoites and tachyzoites isolation from vitreous of atypical necrotizing retinitis

Authors: Ranju Kharel(Sitaula), Sagun Narayan Joshi, Ranjit Sah, Sushila Khadka, Anadi Khatri(KC), Bharat Mani Pokharel

Published in: Journal of Ophthalmic Inflammation and Infection | Issue 1/2018

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Abstract

Background

Detection of Toxoplasma gondii cysts in vitreous of immunocompetent patient with necrotizing retinitis is extremely rare. We herein report the isolation of Toxoplasma bradyzoites and tachyzoites from the vitreous of healthy person.

Results

A 19-year-old immunocompetent female presented with sudden loss of vision in left eye since 1 week. The BCVA was 6/6 and HM in right and left eye. The left eye finding was suggestive of diffuse necrotizing retinitis with retinal detachment. The IgM and IgG for TORCH infection were negative and HIV, HCV and HBsAg tests were also non reactive. The patient underwent diagnostic and therapeutic vitrectomy with silicon oil installation.
The vitreous toxoplasma IgG titre was found to be significantly raised to 1:16. Bradyzoites of toxoplasma were identified in H&E staining and tachyzoites of Toxoplasma were identified in Giemsa staining of vitreous sample. She received oral clindamycin and oral corticosteroid but the vision could not be restored in left eye.

Conclusion

Hence, atypical toxoplasmosis with necrotizing retinitis is a fulminant condition with the diagnostic and therapeutic challenge.
Literature
1.
go back to reference Nussenblatt RB (2010) Ocular toxoplasmosis. In: Uveitis: fundamentals and clinical practice, 4th edn. 14 pp 190-209 Nussenblatt RB (2010) Ocular toxoplasmosis. In: Uveitis: fundamentals and clinical practice, 4th edn. 14 pp 190-209
2.
go back to reference Commodaro AG, Belfort RN, Rizzo LV, Muccioli C, Silveira C, Burnier MN Jr et al (2009) Ocular toxoplasmosis: an update and review of the literature. Mem Inst Oswaldo Cruz 104(2):345–350CrossRefPubMed Commodaro AG, Belfort RN, Rizzo LV, Muccioli C, Silveira C, Burnier MN Jr et al (2009) Ocular toxoplasmosis: an update and review of the literature. Mem Inst Oswaldo Cruz 104(2):345–350CrossRefPubMed
4.
go back to reference Nijhawan R, Bansal R, Gupta N, Beke N, Kulkarni P, Gupta A (2013) Intraocular cysts of Toxoplasma gondii in patients with necrotizing retinitis following periocular/intraocular triamcinolone injection. Ocul Immunol Inflamm 21(5):396–399CrossRefPubMed Nijhawan R, Bansal R, Gupta N, Beke N, Kulkarni P, Gupta A (2013) Intraocular cysts of Toxoplasma gondii in patients with necrotizing retinitis following periocular/intraocular triamcinolone injection. Ocul Immunol Inflamm 21(5):396–399CrossRefPubMed
5.
go back to reference Brezin AP, Kasner L, Thulliez P, Li Q, Daffos F, Nussenblatt RB et al (1994) Ocular toxoplasmosis in the fetus: immunohistochemistry analysis and DNA amplification. Retina 14(1):19–26CrossRefPubMed Brezin AP, Kasner L, Thulliez P, Li Q, Daffos F, Nussenblatt RB et al (1994) Ocular toxoplasmosis in the fetus: immunohistochemistry analysis and DNA amplification. Retina 14(1):19–26CrossRefPubMed
6.
go back to reference Furtado JM, Bharadwaj AS, Chipps TJ, Pan Y, Ashander LM, Smith JR (2012) Toxoplasma gondii tachyzoites cross retinal endothelium assisted by intercellular adhesion molecule-1 in vitro. Immunol Cell Biol 90(9):912–915CrossRefPubMedPubMedCentral Furtado JM, Bharadwaj AS, Chipps TJ, Pan Y, Ashander LM, Smith JR (2012) Toxoplasma gondii tachyzoites cross retinal endothelium assisted by intercellular adhesion molecule-1 in vitro. Immunol Cell Biol 90(9):912–915CrossRefPubMedPubMedCentral
7.
go back to reference Greven CM, Teot LA (1994) Cytologic identification of Toxoplasma gondii from vitreous fluid. Arch Ophthalmol 112(8):1086–1088CrossRefPubMed Greven CM, Teot LA (1994) Cytologic identification of Toxoplasma gondii from vitreous fluid. Arch Ophthalmol 112(8):1086–1088CrossRefPubMed
8.
go back to reference Adán A, Sole M, Mateo C, Jean AS, Alforja S (2012) Cytologic identification of Toxoplasma gondii from subretinal aspirate. Acta Ophthalmol 90(4):392–393CrossRefPubMed Adán A, Sole M, Mateo C, Jean AS, Alforja S (2012) Cytologic identification of Toxoplasma gondii from subretinal aspirate. Acta Ophthalmol 90(4):392–393CrossRefPubMed
9.
go back to reference Yeo JH, Jakobiec FA, Iwamoto T, Richard G, Kreissig I (1983) Opportunistic toxoplasmic retinochoroiditis following chemotherapy for systemic lymphoma: a light and electron microscopic study. Ophthalmology 90(8):885–898CrossRefPubMed Yeo JH, Jakobiec FA, Iwamoto T, Richard G, Kreissig I (1983) Opportunistic toxoplasmic retinochoroiditis following chemotherapy for systemic lymphoma: a light and electron microscopic study. Ophthalmology 90(8):885–898CrossRefPubMed
10.
go back to reference Rao NA, Font RL (1977) Toxoplasmic retinochoroiditis: electron-microscopic and immunofluorescence studies of formalin-fixed tissue. Arch Ophthalmol 95(2):273–277CrossRefPubMed Rao NA, Font RL (1977) Toxoplasmic retinochoroiditis: electron-microscopic and immunofluorescence studies of formalin-fixed tissue. Arch Ophthalmol 95(2):273–277CrossRefPubMed
11.
go back to reference Belfort RN, Rasmussen S, Kherani A, Lodha N, Williams G, Fernandes BF et al (2010) Bilateral progressive necrotizing retinochoroiditis in an immunocompromised patient: histopathological diagnosis. Acta Ophthalmol 88(5):614–615CrossRefPubMed Belfort RN, Rasmussen S, Kherani A, Lodha N, Williams G, Fernandes BF et al (2010) Bilateral progressive necrotizing retinochoroiditis in an immunocompromised patient: histopathological diagnosis. Acta Ophthalmol 88(5):614–615CrossRefPubMed
12.
go back to reference Balansard B, Bodaghi B, Cassoux N, Fardeau C, Romand S, Rozenberg F et al (2005) Necrotising retinopathies simulating acute retinal necrosis syndrome. Br J Ophthalmol 89(1):96–101CrossRefPubMedPubMedCentral Balansard B, Bodaghi B, Cassoux N, Fardeau C, Romand S, Rozenberg F et al (2005) Necrotising retinopathies simulating acute retinal necrosis syndrome. Br J Ophthalmol 89(1):96–101CrossRefPubMedPubMedCentral
13.
go back to reference Villard O, Filisetti D, Roch-Deries F, Garweg J, Flament J, Candolfi E (2003) Comparison of enzyme-linked immunosorbent assay, immunoblotting, and PCR for diagnosis of toxoplasmic chorioretinitis. J Clin Microbiol 41(8):3537–3541CrossRefPubMedPubMedCentral Villard O, Filisetti D, Roch-Deries F, Garweg J, Flament J, Candolfi E (2003) Comparison of enzyme-linked immunosorbent assay, immunoblotting, and PCR for diagnosis of toxoplasmic chorioretinitis. J Clin Microbiol 41(8):3537–3541CrossRefPubMedPubMedCentral
14.
go back to reference Rai SKUM, Shrestha HG (2003) Toxoplasma infection in selected patients in Kathmandu, Nepal. Nepal Med Coll J 5(2):89–91PubMed Rai SKUM, Shrestha HG (2003) Toxoplasma infection in selected patients in Kathmandu, Nepal. Nepal Med Coll J 5(2):89–91PubMed
15.
go back to reference Kijlstra A, Luyendijk L, Baarsma G, Rothova A, Schweitzer C, Timmerman Z et al (1989) Aqueous humor analysis as a diagnostic tool in toxoplasma uveitis. Int Ophthalmol 13(6):383–386CrossRefPubMed Kijlstra A, Luyendijk L, Baarsma G, Rothova A, Schweitzer C, Timmerman Z et al (1989) Aqueous humor analysis as a diagnostic tool in toxoplasma uveitis. Int Ophthalmol 13(6):383–386CrossRefPubMed
16.
go back to reference Fawzy M, Mahmoud L, El Gindy A, Hegab M, Bahgat M (1998) Value of estimating intraocular antibody production in diagnosis of typical and atypical lesions of ocular toxoplasmosis. J Egypt Soc Parasitol 29(3):735–743 Fawzy M, Mahmoud L, El Gindy A, Hegab M, Bahgat M (1998) Value of estimating intraocular antibody production in diagnosis of typical and atypical lesions of ocular toxoplasmosis. J Egypt Soc Parasitol 29(3):735–743
17.
go back to reference De Groot-Mijnes JD, Rothova A, Van Loon AM, Schuller M, Ten Dam-Van Loon NH, De Boer JH et al (2006) Polymerase chain reaction and Goldmann-Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis. Am J Ophthalmol 141(2):313–318CrossRefPubMed De Groot-Mijnes JD, Rothova A, Van Loon AM, Schuller M, Ten Dam-Van Loon NH, De Boer JH et al (2006) Polymerase chain reaction and Goldmann-Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis. Am J Ophthalmol 141(2):313–318CrossRefPubMed
18.
go back to reference Holland GN (2009) Ocular toxoplasmosis: the influence of patient age. Mem Inst Oswaldo Cruz 104(2):351–357CrossRefPubMed Holland GN (2009) Ocular toxoplasmosis: the influence of patient age. Mem Inst Oswaldo Cruz 104(2):351–357CrossRefPubMed
20.
go back to reference Sahm M, Fischer H-G, Gross U, Reiter-Owona I, Seitz HM (1997) Cyst formation by Toxoplasma gondii in vivo and in brain-cell culture: a comparative morphology and immunocytochemistry study. Parasitol Res 83(7):659–665CrossRefPubMed Sahm M, Fischer H-G, Gross U, Reiter-Owona I, Seitz HM (1997) Cyst formation by Toxoplasma gondii in vivo and in brain-cell culture: a comparative morphology and immunocytochemistry study. Parasitol Res 83(7):659–665CrossRefPubMed
Metadata
Title
Toxoplasma gondii bradyzoites and tachyzoites isolation from vitreous of atypical necrotizing retinitis
Authors
Ranju Kharel(Sitaula)
Sagun Narayan Joshi
Ranjit Sah
Sushila Khadka
Anadi Khatri(KC)
Bharat Mani Pokharel
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Journal of Ophthalmic Inflammation and Infection / Issue 1/2018
Electronic ISSN: 1869-5760
DOI
https://doi.org/10.1186/s12348-018-0151-x

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