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Diagnosing superinfection keratitis with multiplex polymerase chain reaction.
J Infect Chemother 2018; 24(12):1004-1008JI

Abstract

PURPOSE

To report the potential usefulness of multiplex polymerase chain reaction (mPCR) for diagnosing superinfection keratitis caused by herpes simplex virus-1 (HSV-1), bacteria and fungus.

METHODS

Case series. Corneal scrapings were analyzed with mPCR for human herpes virus 1-8, bacterial 16S ribosomal DNA (rDNA) and fungal 28S rDNA.

RESULTS

Case 1 was a 69-year-old man who presented with refractory infectious keratitis. PCR examination was positive for bacterial 16S rDNA and negative for fungal 28S rDNA. HSV-1 was not examined at this time. A geographic ulcer arose after 2 months of intensive antibacterial treatment. Herpes simplex keratitis (HSK) was suspected; PCR analysis was positive for HSV-1. Corneal scrapings obtained at the initial visit were re-analyzed and found to be HSV-1 positive. Thus, it turned out that this was a case of superinfection keratitis caused by bacteria and HSV-1. Case 2 was a 60-year-old man with corneal ulcer who had received unsuccessful treatment with antibiotics. mPCR analysis was positive for HSV-1, bacterial 16S rDNA and fungal 28S rDNA. The patient was diagnosed with superinfection keratitis caused by HSV-1, bacteria and fungus. Case 3 was an 82-year-old woman who had been treated for HSK and then developed bacterial keratitis during treatment. mPCR analysis was positive for HSV-1 and bacterial 16S rDNA. The patient was diagnosed with superinfection keratitis caused by HSV-1 and bacteria.

CONCLUSION

Superinfection keratitis is hard to diagnose because of its atypical manifestation. mPCR has the potential to allow prompt diagnosis and appropriate treatment in these cases.

Authors+Show Affiliations

Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: hari0208pota@oph.med.tohoku.ac.jp.Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan.Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Kobe, Hyogo, Japan.Department of Virology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.Department of Virology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30006249

Citation

Yoshida, Masaaki, et al. "Diagnosing Superinfection Keratitis With Multiplex Polymerase Chain Reaction." Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, vol. 24, no. 12, 2018, pp. 1004-1008.
Yoshida M, Hariya T, Yokokura S, et al. Diagnosing superinfection keratitis with multiplex polymerase chain reaction. J Infect Chemother. 2018;24(12):1004-1008.
Yoshida, M., Hariya, T., Yokokura, S., Maruyama, K., Sato, K., Sugita, S., ... Nakazawa, T. (2018). Diagnosing superinfection keratitis with multiplex polymerase chain reaction. Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, 24(12), pp. 1004-1008. doi:10.1016/j.jiac.2018.06.012.
Yoshida M, et al. Diagnosing Superinfection Keratitis With Multiplex Polymerase Chain Reaction. J Infect Chemother. 2018;24(12):1004-1008. PubMed PMID: 30006249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosing superinfection keratitis with multiplex polymerase chain reaction. AU - Yoshida,Masaaki, AU - Hariya,Takehiro, AU - Yokokura,Shunji, AU - Maruyama,Kazuichi, AU - Sato,Kota, AU - Sugita,Sunao, AU - Tomaru,Yasuhiro, AU - Shimizu,Norio, AU - Nakazawa,Toru, Y1 - 2018/07/11/ PY - 2018/03/13/received PY - 2018/06/16/revised PY - 2018/06/21/accepted PY - 2018/7/15/pubmed PY - 2019/1/29/medline PY - 2018/7/15/entrez KW - Bacterial 16S rDNA KW - Fungal 28S rDNA KW - Herpes simplex virus KW - Multiplex polymerase chain reaction KW - Superinfection keratitis SP - 1004 EP - 1008 JF - Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy JO - J. Infect. Chemother. VL - 24 IS - 12 N2 - PURPOSE: To report the potential usefulness of multiplex polymerase chain reaction (mPCR) for diagnosing superinfection keratitis caused by herpes simplex virus-1 (HSV-1), bacteria and fungus. METHODS: Case series. Corneal scrapings were analyzed with mPCR for human herpes virus 1-8, bacterial 16S ribosomal DNA (rDNA) and fungal 28S rDNA. RESULTS: Case 1 was a 69-year-old man who presented with refractory infectious keratitis. PCR examination was positive for bacterial 16S rDNA and negative for fungal 28S rDNA. HSV-1 was not examined at this time. A geographic ulcer arose after 2 months of intensive antibacterial treatment. Herpes simplex keratitis (HSK) was suspected; PCR analysis was positive for HSV-1. Corneal scrapings obtained at the initial visit were re-analyzed and found to be HSV-1 positive. Thus, it turned out that this was a case of superinfection keratitis caused by bacteria and HSV-1. Case 2 was a 60-year-old man with corneal ulcer who had received unsuccessful treatment with antibiotics. mPCR analysis was positive for HSV-1, bacterial 16S rDNA and fungal 28S rDNA. The patient was diagnosed with superinfection keratitis caused by HSV-1, bacteria and fungus. Case 3 was an 82-year-old woman who had been treated for HSK and then developed bacterial keratitis during treatment. mPCR analysis was positive for HSV-1 and bacterial 16S rDNA. The patient was diagnosed with superinfection keratitis caused by HSV-1 and bacteria. CONCLUSION: Superinfection keratitis is hard to diagnose because of its atypical manifestation. mPCR has the potential to allow prompt diagnosis and appropriate treatment in these cases. SN - 1437-7780 UR - https://www.unboundmedicine.com/medline/citation/30006249/Diagnosing_superinfection_keratitis_with_multiplex_polymerase_chain_reaction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1341-321X(18)30185-5 DB - PRIME DP - Unbound Medicine ER -