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Purpose: To study infectious agents associated with multifocal serpiginoid choroiditis (MSC) based on polymerase chain reaction (PCR) evaluation and specific anti-microbial therapy., Methods: Retrospective review of medical records., Results: Thirteen patients with MSC were evaluated with PCR for the following organisms: Mycobacterium tuberculosis (MTB), herpes simplex virus 1 (HSV 1), varicella zoster virus (VZV), and cytomegalovirus (CMV). Nine (69.2%) were PCR positive for one or more organisms. Seven (53.8%) were positive for MTB, 3 (23.1%) for CMV (1 positive for both MTB and CMV), and 1 (7.6%) for both HSV 1 and MTB. All 13 patients received anti-TB therapy and corticosteroids. Nine patients completed 6 months follow-up; 6 resolved completely, 2 continued to have active lesions, while 1 CMV PCR-positive patient required additional valgancyclovir therapy., Conclusions: TB is the most important etiology for MSC in endemic countries. The role of herpes viruses in MSC remains unclear and needs further investigation.

We report the use of DNA chip technology in the identification of Toxoplasma gondii as the etiological agent in two patients with recurrent intermediate uveitis (IU). Both patients had recurrent episodes of vitritis (with no focal retinochoroidal lesion) over varying time intervals and were diagnosed to have IU. The tuberculin test was negative in both. Blood counts, erythrocyte sedimentation rate, and serum angiotensin convertase enzyme levels were normal. In both cases, the vitreous fluid tested positive for the T. gondii DNA sequence by using a uveitis DNA chip (XCyton Pvt. Ltd., Bangalore, India). It contained complimentary sequences to "signature genes" of T. gondii, Mycobacterium tuberculosis, M. chelonae, and M. fortuitum. The enzyme-linked immunosorbent assay (ELISA) detected elevated serum antitoxoplasma IgG levels in both. They responded to the antitoxoplasma therapy with oral co-trimoxazole (and additional intravitreal clindamycin in patient 1), with no recurrence during follow-ups of 6 and 8 months, respectively.

Objectives: To report the microbiological spectrum of conjunctival flora and prevalence of biofilm-forming Methicillin-resistant Staphylococcus aureus (MRSA) in conjunctival flora in chronic dacryocystitis.Design: Prospective, case-control study.Methods: We included patients with unilateral chronic dacryocystitis, and their unaffected eyes as control. Microbiological profile and antibiotic susceptibility of the isolates was determined by standard microbiological procedures. S. aureus isolates were further evaluated for Methicillin resistance by Oxacillin resistance screening agar method and mecA polymerase chain reaction (PCR) and for biofilm synthesis by Congo red agar method, Microtitre plate (MTP) assay, and ica A and ica D PCR.Results: We found 95 patients with unilateral chronic dacryocystitis. Aerobic Gram-positive isolates (74.2%, n = 72) were more than Gram-negative (25.7%, n = 25) or anaerobic isolates (20.5%, n = 25). S. aureus was most common (46.4%, n = 45), followed by Pseudomonas aeruginosa (10.3%, n = 10). Gram-positive isolates showed highest sensitivity to Linezolid (100%) and higher generation fluoroquinolones. Gram-negative isolates showed good sensitivity (>90%) to all tested antibiotics. S. aureus isolates showed MRSA prevalence as 93.5% and 96.9% by Oxacillin resistance screening agar method and mecA PCR, respectively. Biofilm formation was found in 71.8% MRSA isolates by MTP assay and 58.1% MRSA isolates were resistant to ≥3 classes of antibiotics.Conclusions: Gram-positive organisms, specifically S. aureus, are the major etiological agent in chronic dacryocystitis. There is high prevalence of MRSA in these isolates and concurrent biofilm formation. [ABSTRACT FROM AUTHOR]

A 48-year-old man, on imatinib therapy for chronic myeloid leukemia, developed bilateral retino-choroiditis. Visual acuity was 20/100 and counting fingers at 2 m in both the right and left eye. Vitreous biopsy (left eye) revealed Toxoplasma gondii genome by polymerase chain reaction. Serum anti-toxoplasma IgG levels were significantly elevated. Blood counts were normal. Bcr-Abl/Abl transcript ratio was 0.016%. He was treated with oral co-trimoxazole, to which corticosteroids in tapering doses were added later. Imatinib therapy was continued. After 6 weeks of therapy, all retinal lesions regressed and vision improved to 20/30 and 20/40 in right and left eyes, respectively. [ABSTRACT FROM AUTHOR]