Diagnostic value of polymerase chain reaction in blood and aqueous humor in immunocompetent patients with ocular toxoplasmosis.
OBJECTIVE
To evaluate the diagnostic value of polymerase chain reaction (PCR) in blood and aqueous humor samples from immunocompetent patients with reactivated ocular toxoplasmosis.


METHODS
Group 1 was composed of seven patients with a clinical diagnosis of reactivated ocular toxoplasmosis. Group 2 consisted of 33 controls. In each subject, blood and aqueous humor samples were obtained for detection of Toxoplasma gondii DNA by means of simple PCR, seminested PCR, and Southern blot hybridization.


RESULTS
Group 1: Simple PCR was positive in 3 of 7 blood samples (42%) and in 2 of 7 (28%) aqueous humor samples. Seminested PCR was positive in 4 of 7 (57%) blood samples and in 3 of 7 (42%) aqueous humor samples. Group 2: Simple and seminested PCR were positive in both samples in 2 of 33 (6%) and 4 of 33 (12%), respectively. Sensitivity 57% (18.41-90.10), specificity 87% (71.80-96.60); positive and negative likelihood ratio 4.38 and 0.49, respectively.


CONCLUSIONS
Polymerase chain reaction can be useful for confirming the diagnosis of ocular toxoplasmosis, especially in those eyes where fundus examination does not yield conclusive results. The detection of T. gondii DNA in blood suggests that reactivation of ocular toxoplasmosis cannot be considered a local event.
Figueroa
M S
MS
Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Bou
G
G
Marti-Belda
P
P
Lopez-Velez
R
R
Guerrero
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000469:parasitology*; D015139:Blotting, Southern; D016054:DNA, Protozoan / Q000032:analysis; D004359:Drug Therapy, Combination; D006801:Humans; D007121:Immunocompetence; D002955:Leucovorin / Q000627:therapeutic use; D008875:Middle Aged; D018512:Parasitemia / Q000188:drug therapy / Q000469:parasitology* / Q000473:pathology; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use; D012008:Recurrence; D012680:Sensitivity and Specificity; D013411:Sulfadiazine / Q000627:therapeutic use; D014122:Toxoplasma / Q000235:genetics / Q000302:isolation & purification*; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy / Q000469:parasitology* / Q000473:pathology
D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D013411:Sulfadiazine; D002955:Leucovorin; D011739:Pyrimethamine