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
N1 - Funding Information:
This work was supported by RHOTO Award received by Kazuichi Maruyama. The authors thank Mr. Tim Hilts for reviewing this manuscript.
Publisher Copyright:
© 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2018/12
Y1 - 2018/12
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.
AB - 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.
KW - Bacterial 16S rDNA
KW - Fungal 28S rDNA
KW - Herpes simplex virus
KW - Multiplex polymerase chain reaction
KW - Superinfection keratitis
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U2 - 10.1016/j.jiac.2018.06.012
DO - 10.1016/j.jiac.2018.06.012
M3 - Article
C2 - 30006249
AN - SCOPUS:85049649985
VL - 24
SP - 1004
EP - 1008
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 12
ER -